PMID- 17641610
OWN - NLM
STAT- MEDLINE
DCOM- 20070925
LR  - 20070720
IS  - 1027-6661 (Print)
IS  - 1027-6661 (Linking)
VI  - 12
IP  - 3
DP  - 2006
TI  - The causes of early disorders of cerebral circulation in patients undergoing 
      carotid endarterectomy.
PG  - 21-7
AB  - AIM: to examine hemostasis in patients undergoing carotid endarterectomy as 
      dependent on the course of the short-term postoperative period. MATERIALS AND 
      METHODS: altogether 36 patients who had undergone unilateral carotid 
      endarterectomy (CEAE) were examined. Intraoperatively, all the patients received 
      unfractionated heparin (UFH) in a dose of 80 - 100 IU/kg bw. As dependent on the 
      course of the short-term postoperative period the patients were distributed into 
      two groups: group 1 included 12 patients who developed disorders of cerebral 
      circulation (DCC) within the first hours after operation, group 2 included 24 
      persons with no complications. Plasma-platelet hemostasis, the system of natural 
      anticoagulants and fibrinolysis were examined before, at the end, 6 hours and on 
      the first day after CEAE. RESULTS: prior to operation all the patients had no 
      significant change in the hemostatic system. Toward the end of operation groups 1 
      and 2 did not differ in the basic parameters of the hemostatic system. Group 
      showed a remarkable platelet hyperaggregation. Six hours after operation group 1 
      demonstrated significantly lower values of ACT, BCT, MHO, an appreciably higher 
      value of APTT and pronounced inhibition of fibrinolytic activity associated with 
      platelet hyperaggregation. On the first postoperative day group 1 retained a 
      significantly lower value of BCT, showed a significant lowering of APTT as 
      compared to the previous observation stages and comparatively to group 2, 
      demonstrated a significantly lower activity of AT III and fibrinolysis. At this 
      stage ADO-induced platelet aggregation in group 1 was appreciably higher than in 
      group 2. Platelet hyperaggregation in group 1 patients appeared a first 
      manifestation of consumption coagulopathy. The significantly higher value of APTT 
      mirrored a compensatory output of endogenous heparin. On the first postoperative 
      day group 1 demonstrated a remarkable consumption of endogenous heparin, 
      noticeably lower activity of AT III, material XIIaKDF inhibition, and retained 
      pronounced platelet hyperaggregation. CONCLUSION: the intensity and extent of the 
      atherosclerotic process in the cerebral vessels together with platelet 
      hyperaggregation lead to the rise of the thrombogenic potential and increase the 
      risk of thrombogenic complications in the immediate hours following operation. 
      Antiaggregation and anticoagulation therapy should be instituted in such patients 
      in the preoperative period and resumed directly after operation.
FAU - Morozov, Iu A
AU  - Morozov IuA
AD  - Laboratory of Rapid Diagnosis, Russian Scientific Center of Surgery, RAMS, 
      Moscow, Russia.
FAU - Charnaia, M A
AU  - Charnaia MA
FAU - Gladysheva, V G
AU  - Gladysheva VG
LA  - eng
PT  - Journal Article
PL  - Russia (Federation)
TA  - Angiol Sosud Khir
JT  - Angiologiia i sosudistaia khirurgiia = Angiology and vascular surgery
JID - 9604504
RN  - 0 (Fibrinolytic Agents)
SB  - IM
MH  - Brain/*blood supply
MH  - Carotid Stenosis/*physiopathology/*surgery
MH  - Cerebrovascular Circulation/physiology
MH  - Early Diagnosis
MH  - Endarterectomy, Carotid/*methods
MH  - Fibrinolytic Agents/therapeutic use
MH  - Humans
MH  - International Normalized Ratio
MH  - Partial Thromboplastin Time
MH  - *Postoperative Complications
MH  - Thrombocytosis/*diagnosis/drug therapy/*etiology
EDAT- 2007/07/21 09:00
MHDA- 2007/09/26 09:00
CRDT- 2007/07/21 09:00
PHST- 2007/07/21 09:00 [pubmed]
PHST- 2007/09/26 09:00 [medline]
PHST- 2007/07/21 09:00 [entrez]
PST - ppublish
SO  - Angiol Sosud Khir. 2006;12(3):21-7.