CLINICAL COURSE OF RESTENOSES AFTER CAROT ID ENDARTERECTOMY

Angiologic and neurologic examinations, ultrasonic dopplerography were performed in 89 patients after operation of carotid endarterectomy. P eriod of observation was 6-182 months after operation (61 months on th e average). Positive clinical effect (absence of disorders of cerebral circulation -DCC) was achieved in 91% of cases. The frequency of both repeated transitory ischemic attacks and the strokes was 9%, the best frequency being in patients with initially asymptomatic course. It wa s found that the degree of restenosis directly correlated with frequen cy of neurologic symptom development: there were no repeated DCC in no rmal state of the operated artery. Meanwhile DCC frequency was less th an 4% In cases with the degree of restenoses less than 60% and was equ al to 15,8% in more than 60% restenoses. DCC were more frequently foun d in occlusion of internal carotid artery. Rather favourable course of restenoses of carotid artery was also conditioned by low content of t he plaques dangerous in terms of embolism. Progression of atherosclero tic damages in other parts of extracranial arteries promoted clinical manifestation of cerebral ischemia. Moreover, negative neurologic dyna mics developed in 7% Of the patients with restenoses less than 60%, an d in 13,8% of cases with restenoses more than 60%. The conclusion was made about efficiency of carotid endarterectomy in patients with ather osclerotic damages of carotid arteries. For prevention of repeated DCC it is recommended both to perform conservative therapy after the oper ation and to examine dynamically the patients using ultrasonic doppler ography beginning 6 months after the operation.