Intraoperative thrombosis and recanalization of arteria carotis interna at the stage of eversion carotid endarterectomy operation, appearance of arteria carotis communis dissection which demanded stent installation to patient with dual disaggregant therapy

In the literature, there are some reports of the carotid artery thrombosis cases after carotid endarterectomy performing. More often, thrombosis is detected in the early postoperative period and less commonly verified intraoperatively. Intraoperative carotid artery dissection is also a rare complication of carotid endarterectomy. Due to the small number of such complications cases occurrence, there is no uniform tactic for managing these patients. Some authors report the facts about appropriate using of operative intervention with dual disaggregant therapy or intraoperative heparin injection or other methods for reducing the risk of the operated artery segment thrombosis. The issues of using the intraluminal shunt in case of intraoperative detection of the collateral blood flow insolvency and are not solved. The question of intraoperative control of the patient's neurological status and prevention of embolic complications is not solved too. A clinical case study demonstrating a series of intraoperative complications is presented, including intraoperative thrombosis and subsequent recanalization of the distal section of internal carotid artery during eversion carotid endarterectomy operation and the occurrence of dissection of the common carotid artery after using the intraluminal shunt. The surgical tactics is shown in identifying the specified complications, the discussion of encountered problems is offered to find the way to solve and prevent them. In a proven clinical case, carotid endarterectomy was performed under local anesthesia, and the patient received double disaggregant therapy.

каротидная эндартерэктомия, интраоперационный тромбоз, диссекция артерии, стентирование, двойная дезагрегантная терапия, местная анестезия, carotid endarterectomy, intraoperative thrombosis, artery dissection, stenting, dual antiplatelet therapy, local anesthesia

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