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Asymptomatic carotid stenosis. Problem status and prospective directions for ischemic stroke prediction

Maria Pospelova; Dmitry Zaytsev; Anna Lepekhina; Alexander Efimtsev; Tatyana Mihaylovna Alekseeva; Natalia Evgenievna Ivanova; Maria Topuzova; Vsevolod Zhiltsov;

One of the most actual problems of modern world medicine is the extremely high mortality rate due to diseases of the cardiovascular system in general and ischemic strokes in particular. This indicator will increase 1.5 times according to WHO forecasts over the next 10 years. Therefore, the foreground are the questions of prevention and management the patients with atherosclerotic lesions of the carotid arteries. Surgical treatment of asymptomatic patients with hemodynamically significant stenosis of more than 75 % is generally accepted. However, «asymptomatic» is a patient without stroke and TIA. Such tactics without detecting cognitive impairment, reducing cerebral perfusion, changing the functional connectivity of neural networks (connectopathy), increasing the level of endothelial dysfunction markers, reducing the level of neuromediators, impairment of some neurophysiological indicators. The complexity and multifactorial nature of these changes dictate the need to create a new algorithm for managing patients with carotid stenosis.


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Keywords: asymptomatic carotid stenosis, connectivity, cognitive impairment, neural networks, functional MRI

Stavropol State Medical Academy
Pyatigorsk State Research Institute of Balneotherapeutics
Pyatigorsk State Pharmaceutical Academy