[EXTRAANATOMIC ARTERIAL RECONSTRUCTION IN PATIENTS WITH ATEROSCLEROTIC AFFECTION OF THE AORTAL ARCH BRANCHES].

Own experience of extraanatomical reconstruction, made for atherosclerotic affection of the aortal arch branches, was analyzed. A subclavian artery (SA) transposition into common carotid artery (CCA) was conducted for symptomatic subtotal stenosis or occlusion of the SA I segment. While extension of atherosclerotic process beyond boundaries of the SA I segment or technical difficulties a carotid-subclavian shunting was preferred. Carotid-carotid shunting was applied in necessity of revascularization of extracranial arteries before endovascular implantation of a stent-graft down to aortal arch with closure of the left CCA branching. The authors consider extraanatomic reconstruction the method of choice in the patients surgical treatment for central atherosclerotic affection of the aortal arch branches, when possibilities of endovascular revascularization methods are exhausted, and this guarantees good and satisfactory results in 91.7% of them.

[Surgical prevention of acute stroke in atherosclerotic carotid stenosis].

The results of carotid endarterectomy performed in 687 patients for the symptomatic and asymptomatic carotid stenosis. Operation in most patients was performed under general anesthesia with intraoperative transcranial oximetry monitoring. Early good and satisfactory postoperative results in patients with symptomatic atherosclerotic carotid stenosis were 95.9% in asymptomatic and 97.2% in symptomatic patients. Hemodynamically significant restenosis over 50% of chink in 3 years follow-up was found in 3.4% patients. Eversion endarterectomy application permite to reduce the duration of the operation. Transcranial oximetry application during surgery helps to realise best surgical tactics and is helpful on decision to use or not an intraoperative shunt.