METHOD FOR PREDICTION OF RISK OF INTRAOPERATIVE ISCHEMIC VASCULAR COMPLICATIONS ACCOMPANYING CAROTID ENDARTERECTOMY

摘要

FIELD: medicine.;SUBSTANCE: invention refers to medicine, namely to ultrasonic diagnostics in neurosurgery, and can be used for prediction of a risk of developing intraoperative, ischemic complications accompanying carotid endarterectomy. Anamnestic data of the patient are collected: history of hypertension (AH), myocardial infarction (MI). In the absence of hypertensive disease, the AH value "0" is assigned, in the presence of the hypertensive disease of 1st stage – "1", 2nd stage – "2", 3rd stage – "3". In the absence of myocardial infarction in the past medical history, the MI parameter is set to "0" if the myocardial infarction is older than 1 month – "1"; prescription of less than 1 month – "2". Carrying out US duplex scanning of carotid arteries with determining plaque thickness (D) in imaging corresponding to maximum plaque size, and ulceration depth (H) in an atherosclerotic plaque by the degree of the plaque surface contrast defect in the color Doppler mapping (CDM) mapping mode. If ulceration depth H1/3D is detected, this parameter (H;D) is assigned the value "0", if observing 1/3D≤H2/3D, assigning the value "1", if observing a pitting depth H≥2/3D, assigning this parameter the value "2". Contrasted intensified US carotid artery scanning is performed, wherein area of plaques contrast (C) is determined relative to total surface area of plaques (F) in imaging corresponding to maximum size of plaques. When obtaining C1/3F, setting said parameter (C;F) to "0"; at 1/3F≤C1/2F – value "1"; at C≥1/2F is a value of "2". It is followed by bilateral Doppler monitoring of cerebral blood flow with detection of microembolic signals (MES) in cerebral vessels, wherein the number of detected microparticles (S) is determined during the observation hour. If no microparticles are detected, this parameter S is assigned "0", if microparticles are detected, a value corresponding to the number of microparticles is assigned to this parameter. Risk (R) of developing intraoperative ischemic vascular complications is determined by formula R = 27.9 *(AH) + 14.6 * (MI) + 14.9 *(H;D) + 6.5 * (S) + 24.8 * (C;F) – 4.3. When obtaining value R≥24.6 conclude a high risk of developing intraoperative ischemic vascular complications. If R24.6 is obtained, a low risk of developing intraoperative ischemic vascular complications.;EFFECT: method provides determining the risk of developing ischemic stroke during carotid endarterectomy by calculating a risk of developing ischemic stroke during carotid endarterectomy.;1 cl, 3 dwg, 7 tbl, 2 ex