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Prospective multicenter online testing of the carotid endarterectomy risk stratification calculator carotidscore.ru

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Indian Journal of Thoracic and Cardiovascular Surgery Aims and scope Submit manuscript

Abstract

Aim

To evaluate the incidence of complications, including fatal outcomes, ischemic strokes, and transient ischemic attacks, associated with carotid endarterectomy (CEA) in patients categorized as low-, medium-, and high-risk based on their CarotidSCORE (carotidscore.ru).

Material and Methods

This prospective, multicenter study was conducted from January 1, 2022, to December 20, 2022, and enrolled 5,496 patients with stenosis of the internal carotid artery (ICA), who were categorized into four groups according to their risk level. Group 1 (n=1,759) included patients at low risk; Group 2 (n=2,483) included those at medium risk; Group 3 (n=429) included those at high risk, who underwent carotid angioplasty with stenting (CAS) due to the high risk of complications associated with carotid endarterectomy (CEA); and Group 4 (n=825) did not use CarotidSCORE (carotidscore.ru). Patients in Groups 1, 2, and 4 underwent CEA.

Results

During the postoperative hospital stay, the highest number of complications, including fatal outcomes (p=0.0007), ischemic strokes (p<0.0001), and the combined endpoints (p<0.0001) were observed in Group 4. No complications were reported in Group 1.

Conclusion

The use of CarotidSCORE (carotidscore.ru) allows for the identification of high-risk patients, enabling clinicians to opt for CAS instead of CEA and reduce the incidence of complications.

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Fig. 1

Abbreviations

CEA:

Carotid endarterectomy

ICA:

Internal carotid artery

ICAS:

Internal carotid artery stenosis

CAS:

Carotid angioplasty with stenting

CDS:

Color duplex scanning

MI:

Myocardial infarction

TIA:

Transient ischemic attack

BARC:

Bleeding Academic Research Consortium

OR:

Odds ratio

CI:

Confidence interval

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Authors and Affiliations

  1. Kostroma Regional Clinical Hospital Named After Korolev E.I., Kostroma, Russian Federation

    Anton Nikolaevich Kazantsev, Goderzi Bagdavadze, Oleg Lebedev, Otabek Mukhtorov, Mikhail Khetagurov, Petr Palagin & Alexey Sirotkin

  2. Clinic of Cardiac Surgery of the Amur State Medical Academy of the Ministry of Health of Russia, Blagoveshchensk, Russian Federation

    Alexander Korotkikh

  3. Western Regional Center for Modern Medical Technologies, Kutaisi, Georgia

    Merab Dzhanelidze

  4. North-Western State Medical University. Named After I.I. Mechnikov, St. Petersburg, Russian Federation

    Elguja Kharchilava, Nonna Zarkua & Sergey Artyukhov

  5. Novgorod State University Named After Yaroslav the Wise, Veliky Novgorod, Russia

    Elena Alekseeva, Valeria Staroverova & Victoria Koplik

  6. Kemerovo State Medical University, Kemerovo, Russian Federation

    Roman Leader

  7. Regional Clinical Hospital No. 1 Named After. Prof. S.V. Ochapovsky, Krasnodar, Russian Federation

    Aslan Zakeryaev

  8. City Alexander Hospital, St. Petersburg, Russian Federation

    Kristina Zakharova, Konstantin Chernykh, Sergey Artyukhov & Lyudmila Roshkovskaya

  9. Arkhangelsk Regional Clinical Hospital, Arkhangelsk, Russian Federation

    Igor Semyin & Anton Kostenkov

  10. St. Petersburg State University, St. Petersburg, Russian Federation

    Dmitry Shmatov

  11. Yaroslavl State Medical University, St. Petersburg, Yaroslavl, Russia

    Oleg Lebedev

  12. First Moscow State Medical University Named After Sechenov, Moscow, Russian Federation

    Shuowen Wang, Roman Komarov & Yuri Belov

  13. Kostroma Oncological Dispensary, Kostroma, Russian Federation

    Vladimir Unguryan

  14. Clinical Hospital of the Administration of the President of the Russian Federation, Moscow, Russian Federation

    Maxim Chernyavin

  15. Federal State Budgetary Scientific Institution “Russian Scientific Center for Surgery Named After Academician B.V. Petrovsky”, Moscow, Russian Federation

    Yuri Belov

Authors
  1. Anton Nikolaevich Kazantsev
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  2. Alexander Korotkikh
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  3. Merab Dzhanelidze
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  4. Elguja Kharchilava
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  6. Elena Alekseeva
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  7. Valeria Staroverova
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  9. Roman Leader
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  10. Aslan Zakeryaev
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  11. Goderzi Bagdavadze
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  12. Kristina Zakharova
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  13. Igor Semyin
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  14. Anton Kostenkov
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  15. Konstantin Chernykh
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  16. Dmitry Shmatov
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  17. Oleg Lebedev
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  18. Sergey Artyukhov
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  19. Otabek Mukhtorov
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  20. Shuowen Wang
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  21. Roman Komarov
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  22. Lyudmila Roshkovskaya
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  23. Mikhail Khetagurov
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  24. Vladimir Unguryan
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  25. Maxim Chernyavin
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  26. Petr Palagin
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  27. Alexey Sirotkin
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  28. Yuri Belov
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Corresponding author

Correspondence to Anton Nikolaevich Kazantsev.

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Conflict of interest

The authors declare no conflict of interest.

Informed consent

Informed consent was obtained from the patients.

Ethics committee approval

The study was performed in compliance with the ethical principles of conducting scientific medical research involving humans and was approved by the decision of the local ethical committee of the Federal State Budgetary Institution of Higher Education "Amur State Medical Academy" of the Ministry of Health of the Russian Federation (protocol No. 3 dated August 1, 2021).

Human and animal rights statement

The study was performed in accordance with the Good Clinical Practice standards and the principles of the Declaration of Helsinki, did not contradict the Federal Law of the Russian Federation of November 21, 2011 No. April 1, 2016 N 200n "On approval of the rules of good clinical practice".

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Kazantsev, A.N., Korotkikh, A., Dzhanelidze, M. et al. Prospective multicenter online testing of the carotid endarterectomy risk stratification calculator carotidscore.ru. Indian J Thorac Cardiovasc Surg 39, 608–614 (2023). https://doi.org/10.1007/s12055-023-01538-z

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  • DOI: https://doi.org/10.1007/s12055-023-01538-z

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