Kopolovec I. Clinical laboratory and instrumental substantiation of surgical treatment for atherosclerotic lesions of aortic arch branches with the aim of treating and preventing acute cerebrovascular disease.

The results of surgical treatment of 520 patients with atherosclerotic lesions of the extracranial arteries were studied. Symptomatic clinical course was observed in 68.7% of patients, asymptomatic clinical course was found in 31.3% of patients. Among studied biochemical indicators, Lp-PLA2wasthe most reliable one correlating with the structure of atherosclerotic plaque more than with plaque size. The combination of three factors, namely stenosis, instability of atherosclerotic plaque and its inflammation process is one of the leading mechanisms of ACD development. The potential risk of ACD development can be calculated using the formula “Stroke-Stop” proposed by us. CEAwithin 72 hours after stroke onset is recommended for patients with at least one of the following criteria: recurrent transient ischaemic attacks within 24 hours; ischaemic stroke-in-evolution; highly embolic soft atherosclerotic plaque. In case of a combination of coronary and carotid atherosclerotic lesions, simultaneous surgery is recommended for patients with symptomatic ICA stenosis greater than 50%; asymptomatic ICA stenosis greater than 70% in case of contralateral ICA occlusion. The sequence of reconstruction procedures in case of a combination of carotid atherosclerotic lesions and atherosclerotic lesions of other cerebral vascular territories is determined by the criterion of severity degree of dominant atherosclerotic lesion of a particular vascular territory.