Abstract:

The article presents an analysis of the choice of strategy for the treatment of ischemic stroke in the acute period, based on literature review.

Aim: was to develop the concept of effective thromboextraction (TE), based on the evaluation of factors influencing results of reperfusion treatment of ischemic stroke (IS), methods of endovascular restoration of cerebral blood flow

Materials and methods: meta-analysis of 44 sources of domestic and foreign literature is performed. The analysis of factors limiting the effectiveness of various reperfusion approaches and the analysis of modern methods of thrombectomy are performed.

Results: it is established, that SMAT (Solumbra) and PROTECT techniques have an advantage in comparison with aspiration approaches to thrombectomy in reducing the period to full reperfusion; methods with temporary occlusion of the source vessel (BGC) SAVE and PROTECT significantly reduce the risk of stroke spread to new vascular areas of the brain and increase the frequency of successful recanalization.

Conclusion: at present time, the PROTECT is the most effective technique in the frequency of successful recanalization, the degree and speed of achieved reperfusion, as well as in the prevention of distal embolization. Extrapolation of experience and principles from other sections of interventional radiology, development of new methods and strategies of brain reperfusion, depending on the morphology of thromboembolism, its size, localization and extent may contribute to improving results of endovascular treatment of ischemic stroke.

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Abstract:

Article presents case report of successful bifurcation stenting of external and internal iliac arteries ir 64-year old patient, with expressed claudication and vasculogenic impotence. Article shows good immediate and nearest results. 

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Abstract:

Article presents a case of successful re-stenting of the left subclavian artery with good medium-term outcome in 59 years patient with a return of symptoms of vertebrobasilar insufficiency due to proximal fracture of previously implanted stent. The leading cause of stents destruction in the aortic arch branches are excessive mechanical load due to constant compression and/or vessel displacement, its compression due closeness of beating heart and movements of the shoulder girdle, which is likely had happened in our case - fracture of proximal segment. After analyzing the movement of vessels during the cardiac cycle, we found that stents in proximal aortic arch branches had been influenced mainly by bending, tension/compression. As a consequence - metal fatigue, which led it to the progressive destruction. Most stent fractures are asymptomatic, but in case of return of previous clinic - reintervention should be done. In this case, endovascular treatment is considered to be the method of first choice.

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