METHOD FOR CEREBRAL HYPERPERFUSION SYNDROME PREVENTION DURING CAROTID ARTERIES STENTING

摘要

FIELD: medicine.;SUBSTANCE: after transfemoral access to the internal carotid artery, first, a proximal MoMa protection system is installed, then the coronary guide is directed behind the stenosis. A balloon with a diameter of 1.5×20 mm is directed along the guide, and predilation is performed at a pressure of 8 atm. Then the balloon and the guide are removed. Active aspiration is performed through the lumen of the MoMa system. A distal protection system - FilterWire filter is directed behind the stenosis and installed in the angle of mandible projection, in the internal carotid artery projection on the neck, an ultrasonic sensor is installed, and duplex ultrasound (US) of blood flow controlled by the linear blood flow velocity (BFV) value is performed. Under the US control, the proximal balloon of the MoMa protection system is gradually depleted so that the BFV scores do not exceed Vps70 cm/sec. Then, the balloon is re-inflated and repeated predilation is performed in the stenosis area with a balloon of a larger diameter 3.0×20 mm under the rated pressure for 30 s. After balloon removal, repeated aspiration is performed through the MoMa system. Then under the US control, the procedure for proximal balloon depletion is repeated with balloon angioplasty of the MoMa system to achieve residual stenosis of not more than 15% and BFV of not more than Vps70 cm/sec, then the stent is implanted.;EFFECT: method improvement.;1 ex