CHALENGES IN THE ORGANIZATION OF SURGICAL MANAGEMENT FOR PATIENTS WITH CAROTID ARTERY STENOSIS
Authors: Saduakas А.E. , Kurakbaev K.K. , Baimuratova M.A. , Ryskulova A.R. , Popova T.V. , Mukhaliyev Y.Y. 
Published: September 2024

Introduction. The objective of the healthcare system in the country is to provide high-quality medical care for patients with carotid artery stenosis. This condition emerges as a sequelae of systemic atherosclerotic disease, rendering it a multidisciplinary challenge. Any risk factor that predisposes to the progression of atherosclerosis can have undesirable consequences. The prevalence of carotid artery stenosis was established in over one third of asymptomatic patients screened at polyclinics, according to the researchers' findings. It is important for outpatient clinicians to have knowledge and guidance on issues such as early diagnosis and determining the degree of carotid artery stenosis. These factors have long-term prognostic value in preventing ischemic stroke. In conjunction with the routine duplex scanning, primary care physicians (vascular surgeons) should perform CT angiography (CTA) to clarify the nature and degree of tortuosity and the state of the distal arterial channel. At the level of a multidisciplinary hospital, vigilant monitoring for the necessity of reconstructive interventions on the carotid arteries is paramount, particularly within facilities housing both a vascular neurology center and a vascular surgery department. The efficacy of interdisciplinary collaboration is pivotal to the success of outcomes. The integration can be augmented by delineating the coordinating role of the primary care physician in the early identification of adverse clinical events within the population. Study Objective: To scrutinize the capabilities of the system pertaining to informational accessibility concerning the provision conditions of specialized care for individuals afflicted with carotid artery stenosis, emphasizing the mobilization of medical resources and the strategizing of patient management across the continuum of healthcare services. Materials and Methods. The literature search strategy facilitated the identification of 116 potential sources, of which 65 were verified to be suitable found in Scopus, PubMed, MEDLINE, eLIBRARY, Google Scholar, "CyberLeninka". The search depth was 5 years (2017-2022). The search queries were constructed utilizing specific keywords. Results: In this review, we analyzed the literature devoted to the organization of accessibility of healthcare for patients with carotid artery stenosis. Conclusion: Despite certain positive changes in monitoring the health of the population in the healthcare system of the Republic of Kazakhstan, there are still many unresolved issues. They concern the continuing discrepancy between the state's obligations to provide citizens with free medical care and the financial resources allocated for these purposes, the lack of integration between primary health care and hospital doctors on a whole list of unresolved issues. To enhance the delivery of high-tech medical care to CVD patients, we recommend expanding the accessibility of medical service information for primary healthcare specialists and hospitals. Additionally, primary care physicians should provide patients and their families with information on early diagnosis and prevention of carotid artery stenosis. It is possible to improve organizational work by involving outpatient clinic surgeons to increase patient satisfaction. This can be achieved by expanding communication with patients and obtaining information from hospital vascular surgeons about timely and high-quality endarterectomy from the external carotid artery. These measures can create preventive conditions to avoid cerebral hemodynamic disorders. Integration efforts can improve the early detection of adverse clinical events in patient management and increase the use of webinars for knowledge acquisition, thereby enhancing the quality of surgical care.