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A Team of Doctors from Varna Has Joined a Global Scientific Trial on Vascular Surgery of Carotid Stenosis

A team of lecturers at Medical University-Varna and doctors at University Hospital "St. Marina", the only team from Bulgaria, has been invited to join the second stage of a global scientific trial on asymptomatic carotid surgery, headed by Prof. Dr. Alison Holliday from Oxford University and President of the European Society for Vascular Surgery. The team of Bulgarian specialists, headed by Prof. Veselin Petrov, Head of Vascular Surgery Department, Dr. Chavdar Bachvarov and Prof. Dr. Silva Andonova, National Consultant in Interventional Neurology, has applied this highly specialized method in patients with carotid artery stenosis, which prevents future lethal and debilitating impacts of stroke.

The first stage of Asymptomatic Carotid Surgery Trial 1 (ACST-1) has demonstrated that carotid endarterectomy (CEA) is more effective and ensures longer life expectancy in comparison with the best medical treatment. The outcomes were published in Lancet Journal, which has the second impact factor in the world – 56. Prof. Petrov is a quoted in the journal participant from Bulgaria. Asymptomatic Carotid Surgery Trial 2 (ACST-2) aims to compare CEA surgery with carotid artery stenting; the outcomes are to be published again in a prestigious journal, and consequently they will define the world guidelines for behaviour in this pathology. The participants from Bulgaria, Prof. Dr. Veselin Petrov and Dr. Chavdar Bachvarov are presented on the first page of the official site of the trial as specialists who have achieved very high scientific results so far.

"The purpose of carotid surgery is to prevent the adverse effects of carotid artery stenosis due to atherosclerotic disease, i.e. ischemic stroke. Similar to any prophylactic intervention, a careful assessment of the relative benefits and risks of the procedure is required for each patient individually. Currently, at University Hospital "St. Marina" in Varna, we also apply a new procedure for the management of carotid stenosis, called percutaneous transluminal angioplasty (PTA) and stenting," explained Prof. Veselin Petrov.

Carotid artery stenosis is a narrowing or constriction of the inner surface (lumen) of the carotid artery, usually caused by plaques in the artery walls. Pieces of the plaque can embolize distally and cause death of brain tissue. Sometimes the plaque causes primary symptoms that are temporary or transient strokes known as transient ischemic attacks (TIA). By definition, transient ischemic attacks last less than 24 hours, and if they are longer, they become minor or major strokes.


Prof. Dr. Alison Holliday has been a student of Prof. Felix Eastcott, the doctor who has developed a lot of techniques that have saved countless patients and prevented disabilities resulting from stroke in many others, the doctor who has performed the first successful surgery of the carotid artery in the world, and his patient survived 20 years after that. Felix Eastcott, consultant surgeon and deputy director of the surgical unit at St. Mary's Hospital, London, United Kingdom.


Velina Markovska