Objective: Primary aim of investigation was to evaluate the effectiveness of carotid endarterectomy (CEA) in patients with vascular parkinsonism (VP) with stenotic lesions of carotid arteries.

Background: CEA is one of the main procedure in the treatment of cerebrovascular diseases, it was interesting for us to establish the effectiveness of CEA in the treatment of vascular parkinsonism.

Methods: There were operated 40 patients with VP, including 27 men (67.5%) and 13 women (32.5%), who had double-sided hemodynamically significant carotid stenosis. The age of patients ranged from 58 to 72 years (average age was 61,5 ± 4,8). On the background of anti-Parkinsonian therapy it was produced a bilateral CEA to all patients. Transcranial duplex scanning was performed before CEA and 6 months after it. The efficiency of CEA was evaluated by using of: Mini Mental State Examination, (MMSE), Barnes Scale (BARS), overall clinical assessment scale (Clinical Global Impression Scale – CGI) and extrapyramidal symptoms rating scale (ESRS).

Results: In most patients after CEA it was noted increased efficiency. The most significant changes were: improved memory, significantly decreased perseverations and contaminations (p <0.05). Positive dynamics (p > 0.05) was found according to MMSE, BARS, CGI and ESRS scales. It should be noted that after CEA the levodopa dose (in complex treatment) decreased on 125-250 mg/day while the severity of dyskinesia decreased in 47.5% of patients.

Conclusions: On the background of anti-Parkinsonian therapy carotid endarterectomy has a positive dynamics in patients with SP and improves quality of life. CEA allowes to reduce the dose of levodopa and decrease severity of dyskinesia in most patients at the same time.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/efficiency-of-carotid-endarterectomy-in-vascular-parkinsonism-in-patients-with-stenotic-carotid-artery-disease/