CLINICAL EXPERIENCE AND FEATURES OF THE BRAIN PERFUSION MSCT TECHNIQUE FOR SURGICAL CORRECTION OF COMBINED LESIONS OF THE CORONARY AND CAROTID ARTERIES
Keywords:
brain perfusion MSCT, coronary artery disease, carotid artery stenosis, surgical correctioAbstract
This study addresses the critical issue of optimizing surgical strategies for patients with combined coronary and carotid artery lesions through advanced brain perfusion imaging. The aim was to evaluate the clinical utility and technical aspects of brain perfusion MSCT in preoperative planning and postoperative monitoring of patients undergoing combined surgical correction. The study included patients (n=124) with concurrent coronary and carotid artery disease who underwent brain perfusion MSCT before and after surgical intervention. The perfusion protocol was optimized to minimize radiation exposure while maintaining diagnostic accuracy. Key parameters analyzed included cerebral blood flow (CBF), cerebral blood volume (CBV), and mean transit time (MTT). Results demonstrated that brain perfusion MSCT effectively identified perfusion deficits in 78% of cases, influencing surgical strategy in 45% of patients. Post-surgical imaging showed significant improvement in perfusion parameters in 82% of cases. Technical refinements in the MSCT protocol resulted in a 30% reduction in radiation dose without compromising diagnostic quality. This experience suggests that brain perfusion MSCT is an essential tool for surgical planning and outcome assessment in combined coronary-carotid interventions, providing valuable hemodynamic information for optimizing treatment strategies.
References
Dai X, Mook AA, Maor E, Asher E, Yunis A, Xu Yu, Lu
Yu, Liu X, Shu J, Bragazzi N.L. Global, regional and
national burden of coronary heart disease and related
risk factors, 1990-2017: results of the Global Burden of
Disease Study for 2017 a year. Results of Euro Heart J
Qual Care Clin. 2020:qcaa076
Novbar A.N., Gitto M., Howard J.P., Francis D.P., AlLami R. Mortality from Coronary Heart Disease. Clinical
results of cardiovascular surgery. 2019;12(6):e005375.
doi:10.1161/CIRCOUTCOMES.118.005375
Bazylev V.V., Rosseikin E.V., Shmatkov M.G.,
Voevodin A.B. Results of simultaneous open and hybrid
operations in lesions of the coronary and carotid basins.
Federal State Budgetary Institution "Federal Center for
Cardiovascular Surgery", Cardiology and Cardiovascular
Surgery. 2014; 4: 33-38
Mansurov A.A., Ilkhomov O.E., Khalikulov H.G.
Modern aspects of surgical treatment of combined
lesions of coronary and brachiocephalic arteries.
Surgery of Uzbekistan 2021, No.4, 58-64.
Poslussny P., Gorlitzer M., Froshl A., Moidl R., Kauki
M., Weiss G., etc. The results of synchronous carotid
endarterectomy and cardiac surgery: the experience of
a single center. Thoracic. Cardiovascular. Surgery.
; 61: 5.
Poi M.J., Echeverria A., Lin F. Modern treatment of
patients with concomitant diseases of the coronary and
carotid arteries. World Cup 2018;42(1):272-282. doi:
1007/s00268-017-4103-7
Feldman D.N., Swaminathan R.V., Geleris D.D., Okin
P., Minutello R.M., Krishnan W., McCormick DJ,
Bergman J., Singh H., Wong S.K., Kim L.K. Comparison
of trends and results of simultaneous revascularization
of carotid arteries and coronary artery bypass grafting
in the hospital: the experience of the United States with
to 2012. Cardiovascular intervention JACC.
;10(3):286-298. doi: 10.1016/j.jcin.2016.11.032
Oi K., Arai H. Stroke associated with coronary artery
bypass grafting. General thoracic cardiovascular
surgery. September 2015;63(9):487-95. doi:
1007/s11748-015-0572-5,
Taylor S., Walsh E., Strain C. Synchronous CEA and
CABG in asymptomatic carotid artery stenosis: a clinical
case. June 2019, September;37(3):194-198. doi:
1016/June 2019.03.002 10. Zhang
J., Dong Z., Liu P., Fan H., Chen J., Zheng H., Ma B.,
E.Z. Various strategies for simultaneous
revascularization of coronary and carotid arteries - the
experience of a single center. Arch Iran Med., March 1,
;22(3):132-136
Masabni K., Raza S., Blackstone E., Gornik H.L.,
Sabik Y.F. 3rd place. Does preoperative screening for
carotid artery stenosis reduce the risk of stroke in the
perioperative period in patients who have undergone
coronary artery bypass grafting? J Thoracic
cardiovascular surgery. 2015;149(5):1253-60. doi:
1016/j.jtcvs.2015.02.003.
Shahian D.M., H.H., Jacobs J.P., Kurlansky P.A. and
others. The Society of Thoracic Surgeons has developed
a comprehensive indicator of the individual
effectiveness of surgeons in adult cardiac surgery: The
Report of the Task Force on Measuring the Quality of
the Society of Thoracic Surgeons. Ann Thoracic Surgery.
;100(4):1315-24; doi:
1016/j.athoracsur.2015.06.122.
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