Results on surgical treatment of combined inner carotid artery stenosis and tortuousness in acute period of ischemic stroke

Research results on surgical treatment of combined stenosis and tortuousness of aortic arch branches are analyzed. The surgical treatment was performed in the acute period of cerebral circulation disorder. A combination of stenosis and tortuousness was revealed in 112 (39,9 %) out of 281 patients with acute ischemic stroke operated in 2011-2012. The patients with such combined lesions were divided into three groups. Group I included those suffering from IS or transitory ischemic attack (TIA) and operated within two weeks from the onset of acute ischemic stroke, and consisted of 47 patients (42 %), 31 of them male (66 %) and 16 female (34 %). Group II included those who had IS or TIA and were operated 2 to 4 weeks after the onset of acute ischemic stoke, and comprised 10 patients (8,9 %), 8 male (80 %) and 2 female (20 %). Group III included those who had IS and were operated more than a month after the onset of acute ischemic stroke, and consisted of 55 patients (49,1 %), 34 male (61,8 %) and 21 female (38,2 %). In group I, full recovery from neurological deficits was achieved in 16 patients (34 %), partial recovery in 30 patients (63,9 %), and in 1 person (2,1 %) no dynamics of neurological status was observed. Recurrent ischemic stroke did not occur in any of the patients during hospitalization period. In group II, full recovery was registered in 3 persons (30 %), partial recovery in 5 persons (50 %), and insignificant or no improvement in 1 person (10 %). One patient (10 %) suffered from recurrent IS. In group III, 15 patients (27,1 %) showed full and 27 patients (49,1 %) partial recovery, and insignificant dynamics was observed in 11 patients (20%). In two patients, recurrent central neurological deficit was observed, in one case IS and in the other one TIA. Lowering the risk of recurrent «angiogenic» stroke is a major advantage of early operations on carotid arteries in cases of combined stenosis and tortuousness.