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Objective: Intima-media thickness is a response of surgical trauma after carotid endarterectomy. Different surgical techniques give a different reaction of intima-media layer development, and different factors influences intima-media thickening. Severe intimal hyperplasia can be a cause for restenosis of internal carotid artery. The aim of study: to find atherosclerotic risk factors and medical therapy correlations with postoperative carotid intima-media thickness depending from endarterectomy technique.
Methods: Intima-media layer of the internal carotid artery was measured by ultrasound for 104 patients undergoing carotid endarterectomy. Patients were operated in diferent surgical techiques: with primary suture, with synthetic patch and eversion. Carotid ultrasound of postoperative internal carotid artery was performed in the first,third, sixt, twelfth months in postoperative period. There were the following risk factors stated out:smoking, arterial hypertension and diabetes. All patients received aspirin and statin (atorvastatin) therapy in postoperative period.
Results: Intima-media layer tended to increase during the first postoperative year, but there were no significant restenosis observed in the first year period. Assessing correlations of intima-media thickening and the parameters stated in the work objectives, intima-media thickness correlations were found with postoperative statin therapy in patients endarterectomy performed in eversion technique (correlation coefficient (r) = 0,359-0,412)) and with primary suture (r = 0,357-0,456). There were no correlations with intima-media changes in patients who had a surgery with synthetic patch. There were correlation with intima-media thickness and patients age as well in patients who had been performed an endarterectomy with primary suture (r=0,398-0,517) and eversion technique (r=0,364-0,391). All the correlation were weak (r =0,35-0,7), but statistically important(p ≤ 0,05).
Conclusion: In study the following correlations were observed: intima-media layer was thinner in patients receiving statin therapy and in younger patients and patients after endarterectomy performed with primary suture or by eversion technique. In carotid endarterectomy without patch or eversion technique intima-media changes in postoperative period more correspond to atherosclerotic genesis. There is still a need for more investigations in the field of postoperative changes of intima-media layer after carotid endarterectomy.