An anastomosis between the internal carotid and vertebral arteries in the treatment of a patient with bilateral carotid arteries occlusions.

The article presents a case of successful surgical treatment of a patient with progressive chronic cerebral ischemia due to occlusions of both internal carotid arteries combined with occlusion of the vertebral artery in the first and second segments. We describe a surgical technique that includes an auto arterial carotid-subclavian bypass in the third segment of the vertebral artery, with an extracranial portion of the occluded internal carotid artery (after preliminary thromboendarterectomy) being used as a shunt. Previously, the patient had undergone surgery for creating bilateral EICMA. We analyzed the indications for each phase of the surgery with allowance for the peculiarities of compensatory collateral circulation and possible complications of the surgical treatment.