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Clinical significance of predictive factors in development and treatment of carotid restenosis in patients after eversion endarterectomy.

dc.contributor.advisorRadak, Đorđe
dc.contributor.otherOtašević, Petar
dc.contributor.otherDavidović, Lazar
dc.contributor.otherMilojević, Predrag
dc.contributor.otherRančić, Zoran
dc.creatorTanasković, Slobodan
dc.date.accessioned2016-12-30T16:14:03Z
dc.date.available2016-12-30T16:14:03Z
dc.date.issued2016-09-22
dc.identifier.urihttp://eteze.bg.ac.rs/application/showtheses?thesesId=4399
dc.identifier.urihttps://fedorabg.bg.ac.rs/fedora/get/o:14298/bdef:Content/download
dc.identifier.urihttp://vbs.rs/scripts/cobiss?command=DISPLAY&base=70036&RID=48489999
dc.identifier.urihttp://nardus.mpn.gov.rs/123456789/7362
dc.description.abstractUvod: Karotidna endarterektomija je vrlo pouzdana metoda za lečenje simptomatske i asimptomatske visoko-stepene karotidne stenoze. Karotidna restenoza predstavlja ponovno suženje karotidne arterije koje nastaje kao rezultat neointimalne hiperplazije u ranom postoperativnom periodu (unutar 36 meseci) ili rekurentnih aterosklerotskih lezija u kasnijem toku. Nekoliko studija je pokazalo da je povišena koncentracija Creaktivnog proteina (CRP) nezavistan prognostički faktor budućih kardioloških ishemičnih događaja, ali je malo raspoloživih podataka koji govore o povezanosti karotidne ateroskleroze i serumske koncentracije hs-CRP i drugih proteina akutne faze inflamacije. Ciljevi: Cilj naše studije bio je da ispitamo uticaj preoperativno i neposredno post operativno (48h) povišenih vrednosti sistemskih markera inflamacije („high sensitive“ C-reaktivni protein (hs-CRP), C3 komplement i fibrinogen), njihovih oscilacia i uticaj na nastanak karotidne restenoze nakon everzione endarterektomije tokom praćenja. Takođe smo analizarali uticaj infamatorne komponente i strukture karotidnog plaka na nastanak karotidne restenoze kao i uticaj svih faktora rizika i drugih udruženih oboljenja. Poslednji cilj bio je da uporedimo rezultate perkutane angioplastike i ponovnog hirurškog lečenja pacijenata sa karotidnom restenozom uz evaluaciju prediktivnih faktora koji mogu imati uticaja na konačni ishod oba modaliteta lečenja. Materijal i metode: Ispitivanjem obuhvaćeno je 300 pacijenata kojima je na Klinici za Vaskularnu hirurgiju Instituta za kardiovaskularne bolesti „Dedinje“ učinjena everziona karotidna endarterektomija od 1.marta do 1. avgusta 2010. godine. Analizirana je serumska koncentracija „high-sensitive“ C-reaktivnog proteina (hs- CRP), fibrinogena i C3 komplementa na dan operacije neposredno pre enadarterektomije, 48 časova nakon endarterektomije, kao i na redovnim kontrolnim pregledima nakon 1 meseca, 6 meseci, godinu dana i dve godine...sr
dc.description.abstractObjective: Carotid endarterectomy is known as very reliable procedure for symptomatic and asymptomatic carotid stenosis treatment. Carotid restenosis represents recurrent stenosis that occurs as a result of neointimal hyperplasia in the early postoperative period (within 36 months) or recurrent atherosclerotic lesions in the following period. Several studies have shown that increased C-reactive protein (CRP) values is independent prognostic factor of future cardiological ischemic events, but there is a few studies that describe connection between CRP serum concentration, carotid atherosclerosis and other acute inflammatory phasec proteins. Aims: The aim of our study was to examine influence of increased values of markers of systemic inflammation (high sensitivity C-reactive protein (hs-CRP), C3 complement and fibrinogen) taken just before and after the surgery, its oscillations and its mutual impact on carotid restenosis development after eversion endarterectomy. We have also analyzed the impact of inflammatory component and structure of the carotid plaque on carotid restenosis development as well as influence of all risk factors and other comorbidities. The last aim was to compare the outcome of percutaneous angioplasty and “redo” surgical treatment in patients with carotid restenosis with evaluation of predictive factors influencing the final outcome in both treatment modalities. Methodology: In the presented study, 300 patients were included in whom eversion carotid endarterectomy was performed from 1st march till 1st august 2010. on the Vascular surgery Clinic, “Dedinje” cardiovascular Institute. We have analyzed serum concentration of hs-CRP, fibrinogen and C3 complement taken just before the surgery (06h), 48h after the surgery and on the regular check-ups after 1 month, 6 months, one year and two years. In then second part of the presented study we have retrospectively compared the outcomes of endovascular and “redo” surgical treatment of patients with carotid restenosis in the period from 2002. till 2012...en
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dc.languagesr
dc.publisherУниверзитет у Београду, Медицински факултетsr
dc.relationinfo:eu-repo/grantAgreement/MESTD/Integrated and Interdisciplinary Research (IIR or III)/41002/RS//
dc.rightsAutorstvo-Nekomercijalno-Bez prerade 3.0 Srbija (CC BY-NC-ND 3.0)
dc.sourceУниверзитет у Београдуsr
dc.subjectkarotidna restenoza, hs-CRP, inflamacija, karotidna angioplastika, ponovno („redo“) operativno lečenjesr
dc.subjectcarotid restenosis, high-sensitive CRP, inflammation, carotid angioplasty, repeated - „redo“ surgical treatmenten
dc.titleKlinički značaj prediktivnih faktora u nastanku i lečenju karotidne restenoze kod pacijenata nakon everzione endarterektomijesr
dc.title.alternativeClinical significance of predictive factors in development and treatment of carotid restenosis in patients after eversion endarterectomy.en
dc.typePhD thesis
dcterms.abstractРадак, Ђорђе; Милојевић, Предраг; Ранчић, Зоран; Оташевић, Петар; Давидовић, Лазар; Танасковић, Слободан; Клинички значај предиктивних фактора у настанку и лечењу каротидне рестенозе код пацијената након еверзионе ендартеректомије; Клинички значај предиктивних фактора у настанку и лечењу каротидне рестенозе код пацијената након еверзионе ендартеректомије;


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