Online ISSN: 2515-8260

carotid stenosis

Vascular Brain Malformations In Combination With Extracranial Brachiocephalic Artery Lesions

Aleksey Khripun; Aleksandr Pryamikov; Aleksey Mironkov; Sarkis Asratyan; Viktor Suryakhin; Ruslan Loluev; Lyubov Gulina

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 5, Pages 206-213

One of the unresolved problems in vascular surgery and neurosurgery is the
internal carotid artery ex tra and intracranial segments combined lesion, namely the
combination of the arterial aneurysm or vascular brain malformation with extracranial
brachiocephalic arteries lesions. Currently, there are no clear tactical approaches and
recommendations for the brachiocephalic arteries' comorbid pathology treatment. This
article show s the treatment experience of 55 patients with combined lesions of the internal
carotid artery intra and extracranial pool: a combination of the intracranial aneurysm or
vascular br ain malformation with brachiocephalic arteries stenotic lesions or
asymptomatic internal carotid artery pathological deformation at the cervical level.
Clinical cases were accumulated over 6 years (from 2013 to 2019). The incidence of
comorbid pathology wa s 3.5%. The bigger part of brain vascular malformations (53 of 55
patients or 96%) were asymptomatic. The majority of patients with comorbidity were
women 69% or 38 patients )). Surgical activity among the target group of patients was 40%,
22 o f 55 patients were operated on. Repeated ischemic stroke after asymptomatic internal
carotid artery stenting was beared by one patient (4.5%) in the early postoperative period.
Most aneurysms in the first group were localized in the anterior sections of the W illis circ le
(81% versus 11%, p <0.001), saccular aneurysms prevailed (41 patients or 95%). There is an
existing necessity of accumulation brachiocephalic vascular pool comorbid pathology
surgical treatment experience and major studies conduction that should help in the
development of therapeutic algorithms and optimization of surgical tactics for the
brachiocephalic pool combined vascular pathology.