METHOD FOR DOUBLE PROTECTION OF BRAIN DURING CAROTID ARTERIES STENTING IN PATIENTS WITH HIGH RISK OF EMBOLISM

摘要

FIELD: medicine.;SUBSTANCE: angiography of carotid arteries is performed from both sides, significant stenosis or thrombotic occlusion are identified, artery diameter, distal blood flow in intracranial ICA departments are estimated. Then, the diagnostic catheter is replaced by the proximal-distal MoMa protection system. After active aspiration, heparinized 0.9% NaCl solution in combination with the Nimotop vasodilator is introduced dropwise into the internal carotid artery (ICA) lumen through the MoMa system lumen via the side system channel under the control of blood pressure within 130/90-125/85 mm Hg. Through the MoMa system lumen, a filter device is provided for distal FilterWire protection, and installed in the ICA. Predilation is performed in the stenosis area with a balloon suitable for the target vessel size, then the stent is implanted followed by post-dilation with the same balloon. After this, the final aspiration is performed through the lumen of the proximal MoMa protection, the distal balloon in the outer carotid artery and the proximal balloon in the common carotid artery are blown off. Control angiography is performed and the distal protection filter device is removed from the ICA.;EFFECT: method allows to improve the degree of brain protection due to initial installation of the proximal-distal MoMa protection system with the introduction of vasodilators and heparinized solution of NaCl and the subsequent aspiration thrombotic masses, provides distal branches protection against migration of residual thrombotic masses by installation of additional distal protection.;1 ex