Efficacy of the Carotid Endarterectomy in Asymptomatic and Symptomatic Carotid Stenosis and in Patients with Multifocal Atherosclerosis

Aim. The aim of the research was to study the effect of carotid endarterectomy (CEA) at patients with asymptomatic and symptomatic carotid stenosis, also in the patients with multifocal atherosclerosis (MFA): carotid stenosis in patients with peripheral arterial disease (PAD) of the limbs and ischemic heart disease (IHD). Material and methods. Colour Duplex Doppler was used for screening of carotid pathology in 1104 patients with PAD, IHD, transitory ischemic attacks and an ischemic stroke. The group of 205 patients who had stenosis of a. carotis interna >60%, were divided into three subgroups – patients with asymptomatic carotid stenosis (ACS), patients with symptomatic carotid stenosis (SCS) and patients with multifocal atherosclerosis MFA. Results. All 205 patients were subjected to CEA, conducted by a patch or shunt, which was successful performed at 201 patients (98%). Significant improvement of hemodynamic of the regional carotid as well as intracranial arteries on the side of the surgery was determined using Colour Duplex and Transcranial Doppler Sonography (TDS). At a second stage, after the successful CEA, a vascular reconstruction was carried out or an aorto-coronary bypass created in the case of patients with MFA. Conclusion. CEA in the case of patients with asymptomatic and symptomatic carotid stenosis and a concurrent MFA is an efficient curative method of removing the carotid pathology with a minimum percentage of vascular complications.