The case of simultaneous use of direct and endovascular techniques for the reconstruction of occluded brachiocephalic trunk.

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.

Radical removal of a malignant mediastinum hemangioendothelioma with restoration of the main blood supply to the brain.

46 year old man appealed to the Cancer Research Center of RAMS in October 2012 with unverified anterior superior mediastinal tumor, which was diagnosed in 2010. Progressive compartment syndrome of the superior vena cava was observed. On examination: CT, MRI, angiography, histological and cytological examination of biopsy material did not allow to confirm the morphological structure of the tumor.

Carotid endarterectomy in patients with high surgical risk.

Aim of the study to examine the risk factors for carotid endarterectomy (CEA) and their effect on the results of surgical treatment in patients with chronic cerebral ischemia. The study included 340 patients who were operated in the institute from 2007 to 2011. All patients underwent CEA in various modifications.

[Syndrome of cerebral hyperperfusion after carotid endarterectomy].

Unlabelled: The aim of this study was to assess the role of different modalities in early diagnosis of cerebral hyperperfusion syndrome (CHPS) following carotid endarterectomy, as well as to develop effective treatment protocol for abovementioned complication.

Material And Methods: Study group consisted of 61 patient who underwent uni- or bilateral carotid endarterectomy (CEA). Diagnostic modalities included transcranial Doppler study (TCD), cerebral oximetry, perfusion CT scanning and neuropsychological evaluation.