Clinical Physiology of Circulation

Chief Editor

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


Assessment of arterial and venous blood flow in patientswith atherosclerotic damage of brachiocephalic bed

Authors: М.А. Lovrikova1, К.V. Zhmerenetskiy1, V.V. Zadneprovskaya2

Company:
1Far Eastern State Medical University, Ministry of Health of the Russian Federation, ul. Murav'eva-Amurskogo, 35, Khabarovsk, 680000, Russian Federation
 2Postgraduate Institute for Public Health Workers, Ministry of Health of Khabarovsk Krai, ul. Krasnodarskaya, 9, Khabarovsk, 680009, Russian Federation

E-mail: Сведения доступны для зарегистрированных пользователей.

DOI: https://doi.org/10.24022/1814-6910-2018-15-1-40-49

UDC: 616.13/.14-07:616.132.5-004.6

Link: Clinical Physiology of Blood Circulaiton. 2018; 15 (1): 40-49

Quote as: Lovrikova М.А., Zhmerenetskiy К.V., Zadneprovskaya V.V. Assessment of arterial and venous blood flow in patients with atherosclerotic damage of brachiocephalic bed. Klinicheskaya Fiziologiya Krovoobrashcheniya (Clinical Physiology of Circulation, Russian journal). 2018; 15 (1): 40–9 (in Russ.). DOI: 10.24022/1814-6910-2018-15-1-40-49

Received / Accepted:  11.09.2017/31.10.2017

Download
Full text:  

Abstract

Objective. Optimize the ultrasonic scanning of veins and arteries of carotid bed in patients with atherosclerotic lesions of the brachiocephalic arteries allocated for the operation of carotid endarterectomy.

Material and methods. The study included 90 patients with atherosclerotic lesion of arteries of the carotid bed. The group of patients who had more than 60% stenosis degree have undergone endarterectomy from the internal carotid artery in the period from 2011 to 2013. All patients were divided into three groups: the first group included 30 patients with stenosis of the brachiocephalic arteries up to 40%, the 2nd group – 30 patients with stenosis of the brachiocephalic arteries ranged from 40% to 60%. The third group consisted of patients with more than 60% stenosis of the brachiocephalic arteries, and who had persistent clinic transient ischemic attacks. Complex assessment of arterial and venous circulation by ultrasonic scanning have been performed in patients of all groups. It also evaluated such quality signs as headache, tinnitus, dizziness, and gender.

Results. It is established that in cases of severe atherosclerotic lesions of carotid arteries (CA) affects not only the arterial, but also venous circulation. At we studied qualitative characteristics the most pronounced relationship with the percentage of stenosis have such signs as tinnitus, dizziness, and gender. There is a violation of the relationship between linear blood flow velocity (LBFV) of the CCA and IJV. So does the increase in speed performance in IJV and vertebral veins (VV) in clinostasis, without significant increase in LBFV in that veins in orthostasis and preservation of the pulsatile nature of blood flow, which suggests impaired venous outflow.

Conclusion. In the present study it is established that with increase of the degree of stenosis, there was a significant increase in systole-diastolic ratio in CCA, which confirms the increase in the degree of stenosis in the distal common carotid artery (CCA bifurcation) and ICA. The speed of venous blood flow indices in IJV and VV also increasing in clinostasis, without a significant increase of LBFV in that veins in orthostasis, which may indicate the severity of venous outflow disorders.

References

  1. Дударев В.Е. Обоснование хирургического лечения окклюзирующего атеросклероза сонных артерий с помощью неинвазивных методов обследования: Автореф. дис. ... канд. мед. наук. Омск; 1992. [Dudarev V.E. Rationale for surgical treatment of occlusive carotid artery disease using non-invasive methods of examination. Cand. med. sc. Thesises of Diss. Omsk; 1992 (in Russ.).]

  2. Лоенко В.Б., Сорокина Е.А., Смяловский В.Э., Губенко A.B. Структурные особенности окклюзирующего атеросклероза брахиоцефальных артерий и его взаимосвязь с клиническими проявлениями и характером течения заболевания. Сибирский медицинский журнал. 2010: 1; 24–30. [Loenko V.B., Sorokina E.A., Smyalovskiy V.E., Gubenko A.V. Structural features of occlusive atherosclerosis of the brachiocephalic arteries and its relationship with clinical manifestations and nature of the disease. Sibirskiy Meditsinskiy Zhurnal (Siberian Medical Journal, Russian journal). 2010: 1; 24–30 (in Russ.).]

  3. Кузнецов А.Н. Современные принципы лечения мультифокального атеросклероза. Вестник Национального медико-хирургического центра им. Н.И. Пирогова. 2008; 1: 78–83. [Kuznetsov A.N. Modern principles of treatment of multifocal atherosclerosis. Vestnik Natsional’nogo Mediko-Khirurgicheskogo Tsentra imeni N.I. Pirogova (Bulletin of Pirogov’s National Medical Surgical Center, Russian journal). 2008; 1: 78–83 (in Russ.).]

  4. Matsagas M.I., Vasdekis S.N., Gugulakis A.G., Lazaris A., Foteinou M., Sechas M.N. Computer-assisted ultrasonographic analysis of carotid plaques in relation to cere-brovascular symptoms, cerebral infarction, and histology. Ann. Vasc. Surg. 2000: 14; 130–7.

  5. Becker F., Loppinet A. Asymptomatic carotid stenosis at high risk of ipsilateral cerebro-vascular events. Ann. Cardiol. Angiol. 2004; 53; 34–7.

  6. Чернявский А.М., Виноградова Т.Е., Семенова И.И. Эндотелиальная дисфункция у больных с неврологическими проявлениями каротидного атеросклероза. Патология кровообращения и кардиохирургия. 2007: 2; 34–6. [Cherniavskiy A.M., Vinogradova T.E., Semenova I.I. Endothelial dysfunction in patients with neurological manifestations of carotid atherosclerosis. Patologiya Krovoobrashchenia i Kardiokhirurgiya (Pathology of Circulation and Cardiac Surgery, Russian journal). 2007: 2; 34–6 (in Russ.).]

  7. Liapis C., Kakisis J., Kostakis A. Carotid stenosis: factors affecting symptomatology. Stroke. 2001: 32; 2782–6.

  8. Мартынов А.И., Шмырев В.И., Остроумова О.Д., Боброва Т.А., Попова С.А. Особенности поражения белого вещества головного мозга у пожилых больных с артериальной гипертензией. Клиническая медицина. 2000; 6: 11–5. [Martynov A.I., Shmyrev V.I., Ostroumova O.D., Bobrova T.A., Popova S.A. Characteristics of lesions in the white matter of the brain in elderly patients with arterial hypertension. Klinicheskaya Meditsina (Clinical Medicine, Russian journal). 2000; 6: 11–5 (in Russ.).]

  9. Шумилина М.В. Ангиологические основы комплексной ультразвуковой диагностики патологии сосудов. Клиническая физиология кровообращения. 2016; 1: 5–36 [Shumilina M.V. Angiological bases of complex ultrasonic diagnostics of a pathology of vessels. Klinicheskaya Fiziologiya Krovoobrashcheniya (Clinical Physiology of Circulation, Russian journal). 2016; 1: 5–36 (in Russ.).]

  10. Ворлоу Ч.П., Деннис М.С., ван Гейн Ж. Инсульт: Практическое руководство для ведения больных. Пер. с англ. СПб; 1998. [Warlow Ch.P., Dennis M.S., van Gein J. Stroke: Practical guide to patient management. Transl. from Engl. St. Petersburg; 1998 (in Russ.).]

  11. Суслина З.А., Варакин Ю.Я. Артериальная гипертония и профилактика цереброваскулярных заболеваний. Позиция невролога. Атмосфера. Нервные болезни. 2004: 4; 2–9. [Suslina Z.A., Varakin Uu.Ya. Arterial hypertensia and prevention of cerebrovascular diseases. The position of the neurologist. Atmosfera. Nervnye Bolezni (Atmosphere. Nervous diseases, Russian journal). 2004: 4; 2–9 (in Russ.).]

  12. Никитин Ю.М., Белова Л.А., Машин В.В., Белов В.Г., Ниязова Р.М., Лопатко Д.Н. Венозная гемодинамика головного мозга у больных с гипертонической энцефалопатией. Клиническая физиология кровообращения. 2011; 4: 49–54. [Nikitin Yu.M., Belova L.A., Mashin V.V., Belov V.G., Niyazova R.M., Lopatko D.N. Venous hemodynamics of the brain in patients with hypertensive encephalopathy. Klinicheskaya Fiziologiya Krovoobrashcheniya (Clinical Physiology of Circulation, Russian journal). 2011; 4: 49–54 (in Russ.).]

  13. Nicolaides A.N., Kakkos S.K., Kyriacou E., Griffin M., Sabetai M., Thomas D.J. et al. The Asymptomatic Carotid Stenosis and Risk of Stroke (ACSRS) study. Aims and results of quality control. Angiol. 2003: 22; 263–72.

  14. European guidelines on cardiovascular disease and prevention in clinical practice. Eur. J. Cardiovasc. Prevent. Rehabil. 2003: 10; 1–78.

  15. Kluytmans M., van der Grond J., Viergever M.A. Gray matter and white matter perfusion imaging in patients with severe carotid artery lesions. Radiology. 1998: 209; 675–82.

  16. Покровский А.В. Заболевания аорты и ее ветвей. М.: Медицина; 1979. [Pokrovskiy A.V. Diseases of the aorta and its branches. Moscow: Meditsina; 1979 (in Russ.)].

  17. Тодуа Ф.И., Гачечиладзе Д.Г., Ахвледиани М.В. Состояние сонных артерий и основные сосудистые риск-факторы при инфарктах мозга «передней циркуляции». Ангиология и сосудистая хирургия. 2004: 1; 70–6. [Todua F.I., Gachechiladze D.G., Akhvlediani M.V. Condition of the carotid arteries and the main vascular risk factors in heart attacks of the brain "anterior circulation". Angiologiya i Sosudistaya Khirurgiya (Angiology and Vascular Surgery, Russian journal). 2004: 1; 70–6 (in Russ.).]

  18. Верещагин Н.В. Гетерогенность инсульта: взгляд с позиции клинициста. Журнал неврологии и психиатрии им. С.С. Корсакова. Инсульт. 2003: 9; 8–10. [Vereshchagin N.V. The heterogeneity of stroke: a view from the perspective of the Clinician. Zhurnal Nevrologii i Psikhiatrii imeni S.S. Korsakova. Insul’t (Journal of Neurology and Psychiatry. S.S. Korsakov. Stroke, Russian journal). 2003; 9: 8–10 (in Russ.).]

  19. Poulter N.R., Zographos D., Mattin R., Sever P.S., Thom S.M. Concomitant risk factors in hypertensives: a survey of risk factors for cardiovascular disease amongst hypertensives in English general practices. Blood Pressure. 1996: 5; 209–15.

  20. Суслина З.А., Танашян М.М., Ионова В.Г. Ишемический инсульт: кровь, сосудистая стенка, антитромботическая терапия. М.: Медицинская книга; 2005. [Suslina Z.A., Tanashyan M.M., Ionova V.G. Ischemic stroke: blood, vascular wall, antithrombotic therapy. Moscow: Meditsinskaya Kniga; 2005 (in Russ.).]

  21. Танашян М.М., Суслина З.А., Ионова В.Г., Домашенко М.А., Орлов С.В., Чечеткина А.О., Плешкова М.Ю. Состояние функции эндотелия у больных с ишемическим инсультом при различной степени атеросклеротического поражения сонных артерий. Неврологический вестник. 2007; 1: 12–6. [Tanashyan M.M., Suslina Z.A., Ionova V.G., Domashenko M.A., Orlov S.V., Chechetkina A.O., Pleshkova M.Yu. The state of endothelial function in patients with ischemic stroke at different degrees of atherosclerotic lesions of carotid arteries. Nevrologicheskiy Vestnik (Neurological Bulletin, Russian journal). 2007; 1: 12–6 (in Russ.).]

  22. Шумилина М.В. Комплексная ультразвуковая диагностика патологии периферических сосудов: Учебно-методическое руководство. М.; 2012: 206–22. [Shumilina M.V. Complex ultrasound diagnosis of peripheral vascular pathology. Moscow; 2012: 206–22 (in Russ.).]

  23. Шумилина М.В. Нарушения венозного церебрального кровообращения у больных с сердечно-сосудистой патологией: Дис.... д-ра мед. наук. М.; 2002. [Shumilina M.V. Disorders of cerebral venous circulation in patients with cardiovascular disease: Dr. med. sc. Diss. Moscow; 2002 (in Russ.).]

About Authors

  • Lovrikova Marina Aleksandrovna, Postgraduate; orcid.org/0000-0001-5606-2487
  • Zhmerenetskiy Konstantin Vyacheslavovich, Dr. Med. Sc., Corresponding Member of Russian Academy of Scienses, Rector; orcid.org/0000-0003-3286-2636
  • Zadneprovskaya Vera Viktorovna, Cand. Med. Sc., Associate Professor of Chair of Radiological and Functional Diagnostics; orcid.org/0000-0002-7172-8096

 If you found mistakes, select text and press Alt+A