Therapeutic policy in stenosis of the internal carotid artery combined with intracranial vascular malformation

Khripun A.I.¹, Pryamikov A.D.^1,2, Mironkov A.B.^1,2, Gulina L.D.³

1) Department of Surgery and Endoscopy of the Faculty of Additional Professional Education, Russian National Research Medical University named after N.I. Pirogov,
2) Municipal Clinical Hospital named after V.M. Buyanov,
3) Municipal Polyclinic №170, Moscow, Russia

Presented herein is the world experience of surgical treatment and various tactical approaches in a combined lesion of the extracranial and intracranial portions of the internal carotid artery (ICA): a combination of its stenosis or occlusion with vascular malformation of the brain (a cerebral aneurysm, pathological anastomoses, arteriovenous malformations). Also pointed out is the prevalence of the pathology involved, followed by describing various types of surgical policy in this condition: staged and simultaneous interventions, endovascular and standard operative auxiliary techniques. Taking into consideration a low incidence rate of combined pathology of the ICA, there are currently no randomized studies that would make it possible to work out a common tactical approach to management of this cohort of patients. Hence, this vascular and neurosurgical problem appears to require further study.

KEY WORDS: atherosclerosis, carotid artery stenosis, intracranial aneurysm, stroke, subarachnoid haemorrhage.

P. 112

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