Results of extraintracranial microvascular revascularization in symptomatic occlusive-stenotic affections of brachiocephalic arteries
Objective. To specify the indications for creation of extraintracranial microvascular anastomosis and estimation of its efficacy in occlusive-stenotic pathology of brachio-cephalic arteries, basing on complex estimation of cerebral hemodynamics
Materials and methods. Creation of extraintracranial microvascular anastomosis was analyzed in 14 patients with occlusive-stenotic pathology of brachio-cephalic arteries, to whom duplex scanning of the head and neck vessels was conducted, as well as multispiral computed tomographic angiography and cerebral angiography. Hemodynamical estimation of cerebral blood circulation was conducted, using multispiral computed tomographical perfusion.
Results. Multiple occlusive-stenotic pathology of brachiocephalic arteries with predominantly one-sided occlusion or stenosis of carotid arteries - in 14.3% with isolated affection and in 14.3% with cerebral hemodynamical disorders - were diagnozed in 71.4% of patients. Satisfactory passability of extraintracranial microvascular anastomosis, clinical efficacy, improvement of cerebral perfusion were confirmed in all observations in accordance to results of neuro-psychological testing and complex radiological examination. Secondary insult was not registered in no one patient.
Conclusion. Symptomatic affection of carotid arteries, connected with cerebral hemodynamics disorder in combination with cognitive deficiency, constitutes the indications for extraintracranial anastomosis formation in occlusion-stenotic pathology of brachiocephalic arteries. Creation of extraintracranial microvascular anastomosis constitutes the effective preventive procedure for insult in patients, suffering this vascular pathology.
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