The treatment strategy for patients with combination of occlusive-stenotic damages of cervical part of carotid artery and intracranial aneurysms
Abstract
The combination of stenotic changes of cervical part of internal carotid artery (ICA) and intracranial aneurysm (IA) is the rare and insufficiently examined pathology. The frequency of such pathological combination counts to 2,1-4,1% among all patients suffered from hemodynamically significant ICA stenosis and to 8,3-21,4% - among patients with subarachnoid hemorrhage because of IA rupture. The selection of treatment strategy for such patients with combination of ICA stenotic-occlusive damage and IAs currently presents the challenge in response to the features of disease pathogenesis. The undiagnosed IA may cause the life-threatening intracranial hemorrhage after performance of reconstructive operation on extracranial ICA. Meanwhile patients with undiagnosed hemodynamically significant ICA stenosis are in the group of high risk of cerebral ischemia development because of temporary clipping of intracranial arteries during operation on IA. This article presents the literature review concerning treatment strategy with combination of ICA stenotic-occlusive damage and IAs. Nowadays there are no accurate algorithms for treatment of such patients and definite criteria for selection either microsurgical or endovascular operation as well as the order of operations on cervical part of ICA and IA is not clearly defined.
About the Author
D. A. Nekrasov
Государственное бюджетное учреждение здравоохранения Тюменской области «Областная клиническая больница №2»
Russian Federation
Russian Federation
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Review
For citations:
Nekrasov D.A. The treatment strategy for patients with combination of occlusive-stenotic damages of cervical part of carotid artery and intracranial aneurysms. Russian journal of neurosurgery. 2016;(4):108-114. (In Russ.)
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