HEMODYNAMIC EFFICACY OF EXTRA-INTRACRANIAL MICROANASTOMOSIS (EICMA) IN UNILATERAL OCCLUSION OF THE INTERNAL CAROTID-ARTERY

The physicians of the A. N. Bakulev Institute for Cardiovascular Surgery examined 64 patients with unilateral atherosclerotic occlusion of the internal carotid artery (ICA). TCDG and angiography were employed before and after establishment of EICMA. TCDG proved highly informative in assessment of collateral circulation (sensitivity 95.6%). Indications to EICMA should be based on overall account of initial stage of cerebrovascular insufficiency and collateral circulation. EICMA is indicated for patients with compensated and relatively compensated cerebrovascular insufficiency (trasient ischemic attacks, minor apoplexy, dyscirculatory encephalopathy), residue sequalae of ischemic apoplexy stroke, baseline poor collateral circulation. Differentiated approach to EICMA establishment allows improved outcomes of the surgery and revision of common among angio-neurosurgeons attitude to the above surgery in ICA occlusion.