Objective:

To determine the predictive factors that influence the surgical reconstruction of symptomatic dolicoarteriopathies (DAP) in the internal carotid artery (ICA).

Methods:

Retrospective analysis of patients who underwent surgical reconstruction of (DAP) type kinking or coiling of the ICA from January 2016 to March 2019. Demographic variables were reviewed and a bivariate analysis was performed in order to determine the dependence between them and its influence on anatomical, hemodynamic correction and presence of complications. Data processing was performed with the SPSS program. Statistics were used as appropriate (MannWhitney test, X2, Student’s T). A value of p ≤ 0.05 was preset for statistical significance.

Results:

A total of 111 patients were included, the mean age was 73 years, 87 patients (78.4%) were women. In 68 patients (61.2%) the initial manifestation was a non-hemispheric disorder: syncope 14 cases (12.6%), hyperpulsatile tumor 14 (12.6%) and vestibular disorders 13 cases (11.7%); hemispheric symptoms occurred in 43 cases (38.7%), the most frequent DAPs was the type 3 in 97 cases (87.4%). The coexistence of carotid disease occurred in 47 patients (42.3%). The predictors of hemodynamic correction are simultaneous endarterectomy (p = 0.016) and trans-surgical bleeding (p = 0.027); anatomical correction: preoperative PSV 130 cm/sec (IQ 102-155.75) (p = 0.049) and for the correction of both without the presence of complications: BMI, obesity (p = 0.005), coexistence of non-cardiovascular comorbidities (p = 0.005), type of preoperative symptomatology (p = 0.082) and carotid clamp time (p = 0.045) 30 min (IQR 23-35).

Conclusion:

The surgical correction of DAP is a safe and effective technique; this study demonstrates that there are predictive factors related to the patient, the disease and intraoperatively that may influence the postoperative outcome.

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