Evolution of reconstructive surgery of brachiocephalic arteries

The evolution of reconstructive surgery of brachiocephalic arteries originates from the first operations in the form of vascular ligation to high-tech ones (carotid endarterectomy, carotid stenting, carotid artery prosthetics, carotid-subclavian anastomosis, carotid-subclavian bypass surgery, etc.). This work describes in detail the interrelationships of the development of stroke with the pathology of brachiocephalic arteries (atherosclerosis, dissection, aneurysm, Kimmerle anomaly). Further, the work describes the stages of formation of the main methods of surgical treatment of these pathologies. Various techniques of carotid endarterectomy are considered: classic, eversion, glomus-saving. The article describes the variants of pathological carotid artery tortuosity and ways of its surgical correction, including using endoscopic assistance. Next, the authors analyzed the issues of anesthesia methods, intraoperative cerebral neuroprotection, access to the carotid arteries, and diagnosis of pathology of the brachiocephalic arteries. In conclusion, data on the expansion of the range of surgical interventions and the active involvement of neurosurgeons in reconstructive surgery on brachiocephalic arteries are presented.