Improvement of diagnostics and tactics of surgical treatment of chronic cerebrovascular insufficiency in patients with high perioperative risk

Abstract

Aim. Analysis and systematization of own experience in the treatment of patients with chronic cerebrovascular insufficiency against the background of high surgical risk.
Patients. The results of examination and treatment of 135 patients with chronic cerebrovascular insufficiency with a high risk of perioperative complications were studied – patients with combined atherosclerotic lesions of the carotid and coronary arteries (n=78) and patients with low and critical brain tolerance
to ischemia (n=57).
Results. The angiographic success rate in patients with combined lesions of the carotid and coronary arteries was 100%, the success of the procedure was 89.7%. In the immediate postoperative period, patients
with combined lesions of the carotid and coronary arteries (n=78) developed ischemic stroke in 3 (3.8%)
cases, and acute myocardial infarction was not observed. When analyzing the results of patients with low
and critical brain tolerance to ischemia (n=57 patients), each surgical intervention was considered as a
separate clinical case (114 interventions). In the immediate postoperative period in 108 (94.7%) cases, a
smooth postoperative course was noted. A complicated course was observed in 6 (5.3%) cases, no deaths
were noted.