V.I.Smolanka. . V.I.Smolanka. Surgical Treatment of Acute Brain Ischemia Caused by Pathologies of Extracranial Carotid Arteries.

The thesis is devoted to the problem of surgical treatment of acute brain ischemia caused by extracranial occlusive carotid artery disease. The performed analysis of modern diagnostic tools has enabled the optimal diagnostic algorithm to be elaborated. Differential indications for surgical reconstruction of carotid arteries are formulated based on the process character and localization, changes of the brain tissue, brain hemodynamics and cerebrovascular reactivity. The optimal terms of carotid surgery after stroke are shown to be shortened, the efficiency of the surgery on the third-fourth week after disease onset is proved. Immediate and long-term result show the greater decrease of the neurologic deficiency, reduction of the postoperative stroke rate in comparison with the medical treatment group by factor of 2 during the first month, and by factor of over 3 in the 5-year follow-up period.