[Stagewise bilateral stenting of vertebral arteries in a patient with occlusion of both internal carotid arteries].

The authors describe herein a case report concerning stagewise endovascular treatment of a 69-year-old male patient presenting with occlusion of the right and left internal carotid arteries admitted to Clinical Hospital № 1 of the RF President's Affairs Administration with the following diagnosis: atherosclerotic occlusion of carotid arteries, arterial hypertension, chronic bronchitis, chronic prostatitis, and a history of multiple episodes of unconsciousness. Duplex scanning and angiography of the brachiocephalic arteries revealed occlusion of the both internal carotid arteries, as well as pronounced narrowing of the ostium of the right and left vertebral arteries supplying blood to all portions of the brain. Computed tomography revealed no signs of endured stroke. The first stage consisted in stenting of critical stenosis of the left vertebral artery ostium, followed by stenting of the right vertebral artery ostium performed 2 weeks after (with implanting drug-covered stents «Promus¼ in both cases). The patient was discharged home in a satisfactory condition.

[Landmark of the internal carotid artery stenting, anterior interventricular branch of the left coronary artery and vertebral artery in a patient with multifocal atherosclerosis].

Presented herein is a clinical case report concerning a 59-year-old male patient suffering from multifocal atherosclerosis after endured repeat acute ischaemic attacks in various arterial basins of the brain. Analysing his case history revealed functional class II-IV angina of effort. Ultrasonographic and angiographic findings showed a haemodynamically significant plaque in the ostium of the left internal carotid artery, hypoplasia of the right vertebral artery, a haemodynamically meaningful narrowing of the left vertebral artery, subtotal stenosis of the anterior interventricular branch and pronounced alterations in the right vertebral artery. The first stage of surgery consisted in stenting of the left internal carotid artery and anterior interventricular branch, followed by the second stage consisting in the stenting of the left vertebral artery with an angiographically good outcome. The check-up CT of the brain and 24-hour ECG monitoring showed no negative dynamics. In July 2005, the patient was subjected to craniocerebral microarterial shunting on the right. No relapses of AIAs have so far been observed.