Surgical Treatment Modalities of Carotid Artery Stenosis

The review presents the comparative analysis of current surgical techniques to treat atherosclerotic carotid lesions: carotid stenting and carotid endarterectomy (classical and everting), and describes the advantages and disadvantages of these methods introducing indications and contraindications. Particular emphasis is given to the technique and time to complete carotid endarterectomy. The paper concerns the benefits of a patch over a primary suture, as well as presents the requirements for a patch used in carotid endarterectomy. The authors studied all current materials used for patches, and gave merits and demerits of each material described. The review assesses the feasibility and safety of the more invasive surgical approach for brain revascularization in an acute period of ischemic stroke in strict compliance with surgical indications. The authors have concluded that carotid endarterectomy has a positive effect on cognitive functions in patients in the form of neurological and neuropsychological status improvement. There has been also proved that all above mentioned techniques have no advantages, moreover, they can be mutually complementary and, actually, used in chronic cerebral ischemia treatment.