Cardiovascular Surgery
doi: 10.25005/2074-0581-2020-22-3-440-447
OPTIMIZATION OF SURGICAL TREATMENT OF VERTEBRAL ARTERY TORTUOSITY

D.D. Sultanov1, A.D. Gaibov1, O. Nematzoda2, Kh.A. Yunusov1

1Department of Surgical Diseases № 2, Avicenna Tajik State Medical University, Dushanbe, Republic of Tajikistan
2Republican Scientific Center for Cardiovascular Surgery, Dushanbe, Republic of Tajikistan

Objective: Analysis of the results of standard and optimized surgical treatment of vertebral artery (VA) tortuosity.

Methods: The results of surgical treatment of 52 patients with VA tortuosity were analyzed. There were 18 men (34.6%), and 34 women (65.4%). The age of patients ranged from 23 to 75 years. C- and S-shaped kicking of VA occurred in 38 cases, coiling in 8 cases and Powers syndrome in 6 cases. In 28 (53.8%) patients there was also hypoplasia of the contralateral VA, and in 7 (13.5%) cases there was a pathological deformation of the internal carotid artery.

Results: Depending on the shape of the tortuosity, 4 techniques of reconstructive operations were performed to eliminate tortuosity. In the postoperative period thrombosis of the anastomosis line noted in 2.8% of cases, TIA – in 1.9%, and stroke – in 1.9%. The immediate and long-term results in the groups showed the effectiveness and best results in the group of patients who underwent lateralization of the VA of the author’s modification. Also established that for VA coiling, the method of choice is to move and implantation of VA into the carotid artery.

Conclusion: Correction of VA tortuosity should be differentiated, and the choice of the method of surgery technique should depend on the type of tortuosity and concomitant vascular pathology. The lateral and anterior moving VA ostium helps to reduce the rate of anastomosis thrombosis and greatly facilitates the surgery technique.

Keywords: Vertebral artery, tortuosity, kinking, coiling, vertebrobasilar insufficiency, chronic cerebral ischemia, surgical treatment.

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Authors' information:

Sultanov Dzhavli Davronovich
Doctor of Medical Sciences, Full Professor, Professor of the Department of Surgical Diseases № 2, Avicenna Tajik State Medical University
Researcher ID: AAC-7784-2019
Scopus ID: 36922139600
ORCID ID: 0000-0001-7935-7763
SPIN: 9762-8395
Author ID: 445360
E-mail: sultanov57@mail.ru

Gaibov Alidzhon Dzhuraevich
Corresponding Member of National Academy of Sciences of the Republic of Tajikistan, Doctor of Medical Sciences, Full Professor, Professor of the Department of Surgical Diseases № 2, Avicenna Tajik State Medical University
Researcher ID: AAC-9879-2020
Scopus ID: 6602514987
ORCID ID: 0000-0002-3889-368X
SPIN: 5152-0785
Author ID: 293421
E-mail: gaibov_a.d@mail.ru

Nematzoda Okildzhon
Candidate of Medical Sciences, Leading Researcher of the Republican Scientific Center for Cardiovascular Surgery
Researcher ID: F-8729-2018
Scopus ID: 56469644700
ORCID ID: 0000-0001-7602-7611
SPIN: 2408-9107
Author ID: 929575
E-mail: sadriev_o_n@mail.ru

Yunusov Khuseyn Abdulkhakovich
Postgraduate Student, Department of Surgical Diseases № 2, Avicenna Tajik State Medical University
ORCID ID: 0000-0001-8569-3384
SPIN: 1001-4435
Author ID: 1020861
E-mail: husein-yunusov89@mail.ru

Information about support in the form of grants, equipment, medications

The work was carried out within the framework of the implementation of the “Program of innovative development of the Republic of Tajikistan in the period 2011-2020” and according to the plan of scientific research works of Avicenna Tajik State Medical University and Republican Scientific Center for Cardiovascular Surgery (state registration number – 0113ТД00323). The authors did not receive financial support from manufacturers of medicines and medical equipment

Conflicts of interest: No conflict

Address for correspondence:

Nematzoda Okildzhon
Candidate of Medical Sciences, Leading Researcher of the Republican Scientific Center for Cardiovascular Surgery

734003, Republic of Tajikistan, Dushanbe, Sanoi str., 33

Tel.: +992 (915) 250055

E-mail: sadriev_o_n@mail.ru

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