Anticoagulant therapy in patients with stenosis of the carotid arteries with rhythm disturbance

I. Pulyaeva
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Abstract

The results of examination and treatment by carotid endarterectomy method in 23 patients with atrial fibrillation and lesions of the carotid arteries in the State Institution «V.T. Zaitsev IGES NAMSU» from 2017 to 2019. Antiplatelet agents (aspirin were prescribed in 20 patients, clopidogrel were prescribed in 3 patients) were prescribed due to the presence of cardiovascular disease and previous myocardial infarction. No patient was found to have impaired cerebral circulation in the postoperative period. Tension hematoma was diagnosed in two patients and bleeding from soft tissues, which required revision of the postoperative wound with hemostasis, in one. It has been shown that patients with hemodynamically significant stenosis and unstable plaque of the carotid arteries most often develop atherothrombotic stroke. Patients with stenosis of the carotid arteries and rhythm disturbances should receive antiplatelet and anticoagulant therapy with blood pressure correction in the absence of bleeding.
颈动脉狭窄伴心律失常患者的抗凝治疗
对23例房颤伴颈动脉病变患者行颈动脉内膜切除术检查及治疗的结果进行了分析扎伊采夫IGES NAMSU»2017年至2019年。由于存在心血管疾病和既往心肌梗死,使用抗血小板药物(20例患者使用阿司匹林,3例患者使用氯吡格雷)。术后未发现患者出现脑循环障碍。2例患者被诊断为张力性血肿,1例患者被诊断为软组织出血,需要对术后伤口进行止血。已有研究表明,颈动脉血流动力学显著狭窄和斑块不稳定的患者最常发生动脉粥样硬化性血栓性卒中。颈动脉狭窄和节律紊乱的患者应在无出血的情况下接受抗血小板和抗凝治疗并校正血压。
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