[Endovascular treatment of tandem occlusion of internal carotid and middle cerebral arteries in acute ischemic stroke]. / Éndovaskuliarnoe lechenie tandemnoi ostroi okkliuzii vnutrennei sonnoi i srednei mozgovoi arterii pri ostrom ishemicheskom insul'te.

The paper presents the literature data concerning the results and surgical approaches to the treatment of tandem occlusion in the ICA system. The authors describe two clinical cases of endovascular treatment of tandem ipsilateral occlusion of ICA and middle cerebral artery (MCA). In both cases, the cause of two-level occlusion was complicated by thrombosis atherosclerotic plaque in ICA in the extracranial part with distal thromboembolism in SMA. The antegrade endovascular approach was used in both patients, when ICA was stented at the first stage, and at the second stage aspiration thrombectomy from SMA was performed. The period from the onset of symptoms to revascularization of the ICA system was 285±63 minutes. There were no fatal outcomes, patients were discharged with different neurological deficits: scores of the first patient were as following: 2 points on the NIHSS, 1 point on a Rankin scale, 13 points (initial 12 points on NIHSS) on the Rivermead mobility index and of the second patient: 14 points on the NIHSS, 5 points on a Rankin scale, 0 points (of the original 17 points on the NIHSS) on the Rivermead mobility index.

[Endovascular closure of defects of the interatrial septum and patent foramen ovale].

Endovascular occlusion of defects of the interatrial septum and patent foramen ovale has increasingly been gaining ground in surgical practice. This is predetermined by a shortened hospital stay of the patients and the lack of any cosmetic defects left, as compared with the conventionally performed surgical management. The present review analyses both Russian and foreign literature related to the problem concerned. Indications for and contraindication to this type of operative treatment are determined herein. Also described is the technique of implantation for the present-day types of occluders. A comparative assessment of efficacy and safety of various occlusion systems is given.

[The use of magnetic resonance contrast agents for selective digital subtraction angiography and computed tomography with contrast enhancement].

Allergy to iodine-containing contrast agents is the main contraindication for angiographic examinations of patients. This paper reviews the works of Russian and foreign specialists describing an experience gained with the use of magnetic resonance gadolinium-containing agents possessing radioabsorption properties for digital subtraction angiography and CT, angiography. The authors provide a comparative evaluation of the efficacy of the use of magnetic resonance contrast agents with varying gadolinium concentration. The conclusion is drawn about the comparable diagnostic accuracy of angiograms obtained with the aid of nonionic iodinated contrast agents and monomolar gadolinium-containing contrast agents (Gadovist 1.0).

Endovascular grafting of thoracic aortic pseudoaneurysm after operation for coarctation.

Presented herein is a case of successful repair of thoracic aortic aneurysm by endograft in a female patient 21 years after replacement of the descending aorta for coarctation. During scheduled examination the patient was found to have aneurysm of proximal anastomosis. Additional examination was followed by the stenting of the thoracic aorta using endograft manufactured by the "GORE" Company (USA). The immediate results were classified as good: aneurysm was not opacified, the patency of the vessels of the aortic arch was well preserved. According to the data of check examination carried out 5 months after operation, no graft dislocation was marked, aneurysm was not detectable. The given case demonstrates low-invasive endovascular intervention permitting the avoidance of complicated and traumatic open regrafting of the aorta and attainment of beneficial short- and long-term treatment results.