Quality of life of patients after reconstructive surgery with pathological tortuosity of the internal carotid artery

Aim – to determine how reconstructive surgery affects the quality of life of patients, social func- tions, level of satisfaction with life.

Material and methods. In the Department of Vascular Surgery, Petrovsky National Research Center of Surgery 43 operations for patients with pathological tortuosity of the internal carotid artery were performed. Depending on the indications, the patients underwent resection of the ICA with the reduction of the mouth or prosthetics of the ICA. 36 operated patients assessed the quality of life using the SF-36 questionnaire. We evaluated the criteria of quality of life, such as: self-assessment of health status; physical activity; if the underlying disease interferes with communication between patient and the relatives, acquaintances; problems in the family related to health status; if the underlying disease interferes with social responsibilities.

Results. Analysis of the quality of life of patients after reconstructive operations with pathological tortuosity of the internal carotid artery based on the SF-36 questionnaire showed that in 6–12 months self-esteem of health in patients with initially poor (39%) and good (6%) self- esteem of health status decreased to 8% (p=0.002) and accordingly increased to 39% (p=0.0001). Indicators of self-esteem of health after surgery in 30–36 months were comparable with the results in 6–12 months (p=0.56; p=0.56; p=0.66, respectively).

Conclusion. Reconstructive operations on the internal carotid artery with its pathological tortuosity are not only effective for regression and relief of cerebral and focal neurological symptoms, but also have a positive effect on the quality of life of patients: their emotional status, social functions, well-being and life satisfaction increase.

1. Skvortsova V.I. Reduction of morbidity, mortality and disability from strokes in the Russian Federation. Collection of methodical recommendations, ed. by V.I. Skvortsova. Moscow: Litterra, 2008: 5–6. (in Russian)

2. Belov Yu.V. Clinic and diagnosis of pathological tortuosity of the internal carotid artery. Manual of vascular surgery with Atlas of operative technique. Moscow, 2000: 167–82. (in Russian)

3. Kim B.J., Kim S.M., Kang D.W., et al. Vascular tortuosity may be related to intracranial artery atherosclerosis. Int J Stroke. 2015; 10 (7): 1081–6. DOI: https:// doi.org/10.1111/ijs.12525.

4. Olin J.W., Froehlich J., Gu X., et al. The United States Registry for Fibromuscular Dysplasia: results in the first 447 patients. Circulation. 2012; 125 (25): 3182– 90. DOI: https://doi.org/10.1161/CIRCULATIONAHA.112.091223.

5. Persu A., Touzé E., Mousseaux E., Barral X., Joffre F., Plouin P.F. Diagnosis and management of fibromuscular dysplasia: an expert consensus. Eur J Clin Invest. 2012; 42 (3): 338–47. DOI: https://doi.org/10.1111/j.1365- 2362.2011.02577.x.

6. Pokrovsky A.V., Beloyartsev D.F., Adyrkhaev Z.A. Immediate results of reconstructive operations in pathological deformation of the internal carotid artery. Angiologiya i sosudistaya khirurgiya [Angiology and Vascular Surgery]. 2011; 17 (4): 91–8. (in Russian)

7. Shoikhet Ya.N., Horev N.G., Kulikov V.P. Surgical treatment of pathological tortuosity of the internal carotid artery. Barnaul: publishing house of Altai state medical University; 2003: 86–105. (in Russian)