Abstract
The review presents historical and current data on the results of large-scale randomized trials in the surgical and endovascular treatment of pathologies of the carotid arteries. To this day, the question of the choice of treatment tactics for patients with multifocal atherosclerosis remains relevant. Patients with simultaneous lesions of the coronary and carotid arteries belong to the category of patients with high surgical risk and represent a complex problem with regard to the tactics of management of such groups of patients. Carotid angioplasty with stenting is currently a real alternative to carotid endarterectomy. Given that patients with lesions of the two arterial pools, the coronary and carotid arteries, have an increased risk of death from both myocardial infarction and stroke, in a number of patients with high surgical risk, carotid artery stenting can be performed before myocardial revascularization. In the Russian Federation, the number of patients with combined pathology of the coronary and carotid arteries continues to grow. In developed countries, cerebrovascular diseases with concomitant coronary heart disease occupy a high position (more than 50%) in the structure of overall mortality. The most adverse events are myocardial complications and stroke of the ischemic type. Death resulting from ischemic stroke, according to some data, is about 30%, and the survival rate after 5 years of life is 40%. In the Russian Federation, death as a result of ischemic stroke occurs in about 30% of cases out of the number of all lethal outcomes, and each year this figure increases by 10–12%. Three-tenths of stroke patients return to work, and half of them are of working age. Myocardial infarction is also disappointing, up to 12–15% of patients in the acute stage of the disease die before reaching the hospital. Late admission and inadequate treatment also increase the rate of hospital mortality in acute myocardial infarction.
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About the authors
Eziz D. Sultanov, Postgraduate, orcid.org/0000-0002-3133-1975
