METHOD FOR BRAIN PROTECTION IN CASE OF CAROTID RECONSTRUCTION DURING ACUTE ISCHEMIC STROKE

摘要

FIELD: medicine.;SUBSTANCE: degree of the internal carotid artery (ICA) stenosis is determined and the initial blood pressure (BP) is measured. If the degree of ICA stenosis on the stroke side is up to 79% or in case of contralateral ICA occlusion and initial systolic blood pressure (SBP) less than 150 mm Hg, the main stage of surgery is arterial bed clamping, common carotid artery (CCA) longitudinal dissection with transition to the ICA, temporary internal bypass (TIB) installation, arteriotomical hole suturing, TIB removal and blood flow restoration in the carotid arteries, is performed at SBP level of 100-120 mm Hg, and if the initial SBP is 150 mm Hg and more - the main stage of surgery is carried out at SBP level of 120-140 mm Hg. If the degree of ICA stenosis on the stroke side is 80% or more, the main stage of surgery is arterial bed clamping, CCA dissection with transition to the ICA, arteriotomical hole suturing, TIB removal and blood flow restoration in the carotid arteries, is performed at SBP equal to the initial SBP plus 30%, but no more than 160 mm Hg.;EFFECT: invention reduces intraoperative complications, which is achieved by SBP regulating depending on the degree of stenosis.;2 cl, 1 dwg, 3 ex