Bilateral Dolichoarteriopathies of the Internal Carotid Artery: Surgical Treatment and Results

Abstract

The approach to surgical treatment of symptomatic bilateral dolichoarteriopathies of the internal carotid artery (DICA) remains an unresolved problem today. The aim of this article is to compare the methods of reconstruction of the stage-by-stage surgical treatment of bilateral DICA, depending on the type of deformity. The study included 30 patients with clinical manifestations of cerebrovascular insufficiency (CVI), who were found to have hemodynamically significant bilateral DICA. The patients underwent stage-by-stage operations on both sides, resulting in a total of 60 reconstructive operations on the carotid arteries. Based on the type of reconstruction, the patients were divided into three groups. All three groups showed positive dynamics with relief of the CVI clinical symptoms (p = 0.01), except for patients with persistent residual effects after strokes. Hemodynamic indices in the ICA also normalized after surgery; the linear velocity of blood flow decreased to 0.842 ± 0.087 m/s (p = 0.01) in the first group, 0.825 ± 0.057 m/s (p = 0.01) in the second group, and 0.805 ± 0.083 m/s (p = 0.01) in the third group. The results of the treatment of bilateral DICA showed that with a correctly selected approach to stage-by-stage surgical treatment, it is possible to achieve restoration of blood flow along the internal carotid artery with regression of general cerebral symptoms.

Keywords

bilateral - cerebrovascular insufficiency - dolichoarteriopathy - internal carotid artery - stroke - surgery - results

Authors' Contributions

All authors have critically reviewed and approved the final draft and are responsible for the content and similarity index of the manuscript. Y.D., A.F., I.S., and K.I. contributed to conceptualization, reviewing, research materials, and visualization. T.S., S.S., and R.F. designed the methods and performed statistical analyses. Y.D., T.S., and A.F. performed data interpretation, and writing—original initial draft and final manuscript. All figures presented in this article were created by the authors.

Ethical Approval

The local commission on ethics of National Research Oncology Center LLP, protocol no. 10, October 10, 2021.

Publication History

Article published online:
13 May 2024

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