[Surgical management of patients with occlusion of the internal carotid artery].

The work was aimed at determining appropriate surgical policy in patients presenting with atherosclerotic occlusion of the internal carotid artery (ICA), who had endured ischaemic carotid stroke on the side of the occluded ICA. The study was based on the findings obtained in a comprehensive examination and surgical management of 140 patients. All the 140 patients at the first stage were subjected to surgical resection of the ICA with autovenous plasty of the external carotid artery (ECA). The obtained results were evaluated at 3 and 6 months postoperatively. The outcome measures included studying the clinical course of the disease (assessed by a neuropathologist), the extent of the cerebral perfusion reserve (CPR), the direction the blood flow along the suprapubic artery (SPA), and the type of the collateral compensation of the cerebral blood flow. Failure of the first operation to have turned out either clinically or haemodynamically efficient was followed by determining the indications for carrying out the operation of the extra - intracramal micro anastomosis (EICMA), with the number of such cases amounting to 24 (24.3 %). The surgical policy used to treat the patients with atherosclerotic occlusion of the ICA with endured ischaemic stroke has proved efficient both clinically and haemodynamically in a total of 133 (95%) patients. The findings obtained in the present study made it possible to work out specific indications for performing the operation of the EICMA in patients with occlusion of the CA.