title: [The case of simultaneous use of direct and endovascular techniques for the reconstruction of occluded brachiocephalic trunk].
abstract: The article provides an example of successful surgical treatment of progressive chronic cerebral ischemia due to occlusion of the brachiocephalic trunk and critical stenosis of the right internal carotid artery (more than 85%). We describe a hybrid method of surgical treatment, which include direct access to the neurovascular bundle, retrograde endovascular recanalization following angioplasty and stenting of the brachiocephalic trunk during temporary occlusion of the distal internal carotid artery and carotid endarterectomy. We provide an analysis of indications for each phase of operation considering the features of compensatory collateral circulation in the basin of the occluded brachiocephalic trunk and the possible complications of surgery.
authors.forename: D Iu
authors.initials: DIu
authors.lastname: Usachev
authors.forename: V A
authors.initials: VA
authors.lastname: Lukshin
authors.forename: S B
authors.initials: SB
authors.lastname: Iakovlev
authors.forename: S R
authors.initials: SR
authors.lastname: Arustamian
authors.forename: A V
authors.initials: AV
authors.lastname: Shmigel'skiĭ
authors.forename: A D
authors.initials: AD
authors.lastname: Akhmedov
mesh_terms: D000368:Aged; D002545:Brain Ischemia / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging / Q000601:surgery; D016893:Carotid Stenosis / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery; D057510:Endovascular Procedures; D006801:Humans; D008297:Male; D011859:Radiography; D015607:Stents