Возможности реваскуляризации головного мозга путѐм реконструкции наружной сонной артерии у больных с окклюзией внутренней сонной артерии

Аннотация

Subjects of research: patients with occlusion an internal carotid artery. Purpose of work: improvement of results of surgical treatment of patients with occlusion an internal carotid artery by reconstruction of an external carotid artery. Methods of research: clinical, laboratory, ultrasonic, CT, angiography, statistical. The results obtained and their novelty: In the present work features of brain haemodynamics at patients with occlusion an internal carotid artery at stages of surgical treatment (before the surgical intervention, during the nearest and remote periods) for the first time are studied. Operation on an external carotid artery with endarterectomy not only from its mouth, but also its branches with imposing of a wide patch, for the purpose of involving in a blood-groove of branches an external carotid artery is improved and introduced in practice. For the first time, efficiency of offered operation with the account kliniko-anamncstic features, a condition of brain haemodynamics, an anatomo-functional condition brain is estimated. In clinical practice the algorithm of diagnostics and surgical treatment of patients with occlusion an internal carotid artery in a combination to various degree of a stenosis of the countcrlatcral carotids also is introduced, allowing considerably to lower risk of operative interventions, to define optimum sequence of performance of reconstructive operations and their efficiency, and also, it is essential to improve results of treatment. Practical value: The obtained data on efficiency, safety of operation of a resection and bandaging internal carotid artery with expanded plasticity of external carotid artery, prove expediency of wide introduction of this method of treatment at patients from occlusion an internal carotid artery. Offered operation promotes a desimpatizatsiya of intrakranialny vessels, and improves a brain blood-groove through kollatcralny ways. Introduction in clinical practice of the developed algorithm of diagnostics and treatment of patients from occlusion an internal carotid artery allows, by wide use of ultrasonic and x-ray methods of research, to define the fact of existence of an occlusion an internal carotid artery, a way of kollatcralny compensation of a brain blood-groove and optimum tactics of surgical treatment of this category of patients. Degree of embed and economic effectivity: results of research arc applied in practice of medical and diagnostic work of department of the angioncurology and vascular surgery of 2-clinic of Tashkent Medical Academy. Field of application: medicine, cardiovascular surgery.