Clinical Physiology of Circulation

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, Director of Bakoulev National Medical Research Center for Cardiovascular Surgery

Influence of systemic hemodynamics on retrograde pressure in the internal carotid artery during carotid endarterectomy operation

Authors: A.N. Vachev, M.G. Prozhoga, O.V. Dmitriev

Company:
Samara State Medical University, Ministry of Health of the Russian Federation, ul. Chapaevskaya, 89, Samara, 443099, Russian Federation

E-mail: Сведения доступны для зарегистрированных пользователей.

DOI: https://doi.org/10.24022/1814-6910-2019-16-4-293-298

UDC: 616.133.3-007.271-089.87:612.14

Link: Clinical Physiology of Blood Circulaiton. 2019; 16 (4): 293-298

Quote as: Vachev A.N., Prozhoga M.G., Dmitriev O.V. Influence of systemic hemodynamics on retrograde pressure in the internal carotid artery during carotid endarterectomy operation. Clinical Physiology of Circulation. 2019; 16 (4): 293–8 (in Russ.). DOI: 10.24022/1814-6910-2019-16-4-293-298

Received / Accepted:  17.09.2019/30.09.2019

Full text:  

Abstract

Objective. To determine the significance of central hemodynamic parameters for collateral compensation of impaired main cerebral blood flow during carotid endarterectomy (CEA).
Material and methods. 100 patients who underwent CEA were examined. Systemic arterial hypertension was used to protect the brain from ischemia. To assess cerebral perfusion during compression of the internal carotid artery (ICA), retrograde pressure measurement in the ICA was used. During pre-cerebral vascular clamping, a parallel invasive control of arterial and retrograde pressures was performed. The retrograde pressure index was calculated. By the value of the index, patients were divided into 3 groups. Conducted an analysis of the correlation of systemic and retrograde pressures.
Results. In 61 (61%) patients, a high correlation was observed between retrograde and systemic pressure indices (correlation degree 0.983–0.995). The remaining 39 (39%) patients showed a reduced correlation, but nevertheless remained within a high degree of dependence (the degree of correlation was 0.673–0.886). In this case, a significant difference in the values of systemic blood pressure was revealed in groups with different retrograde pressure indices (p<0.05). The selected groups significantly differed in the level of retrograde pressure in the ICA (p<0.05).
Conclusion. 1. The retrograde pressure in the ICA depends on the level of systemic blood pressure, this dependence is directly proportional and can be high, medium and low. 2. When performing the CEA operation, a systolic retrograde pressure level above 40 mmHg can be achieved by correcting central hemodynamics at the stage of clamping the internal carotid artery.

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About Authors

  • Aleksey N. Vachev, Dr. Med. Sc., Professor, Chief of Chair and Clinic of Faculty Surgery; orcid.org/0000-0002-4925-0129
  • Mikhail G. Prozhoga, Postgraduate, Anesthesiologist-Intensivist; orcid.org/0000-0002-3046-8750
  • Oleg V. Dmitriev, Cand. Med. Sc., Head of Department of Vascular Surgery № 1, Clinics of SSMU; orcid.org/0000-0003-2756-7536


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