Objective – to determine the effectiveness of endovascular revascularization of the carotid pool (carotid stenting) in patients with combined atherosclerotic lesions of the cerebral and coronary arteries, which showed coronary artery bypass grafting (CABG). Materials and methods. 40 patients with combined atherosclerotic lesions of the cerebral and coronary arteries were included in the study. All patients for 14 days before CABG were stented carotid artery. The number of complications and the treatments results were determined. Survival functions were determined to evaluate long-term treatment outcomes over a 10-year follow-up period. Results. 32.5 % of patients had complications after carotid pool revascularization: angina pectoris – 12.5 %, acute myocardial infarction – 2.5 %, transient ischemic attack – 12.5 %, ischemic stroke – 2.5 %, arterial hypotension – 2.5 %. 98.2 % of patients observed positive results of treatment for neurological status. After revascularization of the coronary pool, 45 % of patients had complications: angina – 27.5 %, cardiac arrhythmia – 27.5 %, acute myocardial infarction – 2.5 %, transient ischemic attack – 7.5 %, ischemic stroke – 7.5 %. 83.5 % of patients received positive results of treatment. The 10-year survival rate after surgery was 19 % [34 %; 7 %]. Decrease in survival function was observed uniformly throughout the observation period: 3-year survival – 83 % [92 %; 67 %], 5-year survival – 56 % [70 %; 39 %].Conclusions. Positive results of treatment in patients with combined atherosclerotic lesions of the cerebral and coronary arteries, which performed stenting of the carotid arteries before CABG, are observed in 98.5 % of patients. Carotid artery stenting before CABG is an effective method of preventing cerebral complications in the early postoperative and distant periods. Long-term results of treatment are accompanied by low rates of 5-year and 10-year survival after revascularization of the carotid and coronary pools.

combined atherosclerotic lesions of cerebral and coronary arteries, carotid endarterectomy Ключові слова: поєднані атеросклеротичні ураження церебральних і коронарних артерій, каротидна ендартеректомія Ключевые слова: сочетанные атеросклеротические поражения церебральных и коронарных артерий, каротидная эндартерэктомия Abstract. Results of treatment of patients with combined atherosclerotic lesions of the cerebral and coronary arteries who underwent carotid endarterectomy at different terms before aortic-coronary bypass surgery. Grigoruk S.P., Zorin M.O., Dudukina S.O. The quality of life of patients after surgical interventions in those of with combined atherosclerotic lesions of the cerebral and coronary arteries remains a topical issue of modern medicine. The purpose of the study: to analyze the results of treatment of patients with combined atherosclerotic lesions of the cerebral and coronary arteries in the temporal aspect, who underwent carotid endarterectomy as the first stage of treatment.The results of treatment of 112 patients were analyzed. All patients underwent simultaneous cerebral and coronary angiography. After the operation, if new neurological symptoms appeared or a cardiological pathology progressed, the angiographic study was performed again, and the results of this study were used to decide on further tactics. Treatment results were evaluated 30 days, 5 and 10 years after ACBS. With the revealed indications for ACBS, hemodynamically significant stenoses of the operated carotid artery were found in 10.7% of patients. Stenoses of other cerebral vessels that required surgical correction (opposite ICA, VA) in 7.1%. These patients had cerebral artery stenting before ACBS. In 9.8% of patients, indications were found for stenting of cerebral and coronary arteries, which were performed in one session. In 5.4%, only coronary artery stenting was performed. In the remaining 75 patients without indicated surgical correction of cerebral arteries ACBS was performed. So, in 3-5 years after CEE, ACBS was performed in 35 patients, later than in 5 years -in 40 patients. In the postoperative period, ACBS TIA was registered only in 4%, ischemic stroke -in 5.3%. The total lethality rate is 4%. The 10-year survival rate after myocardial revascularization was 46% [CI 95% 58%; 34%]. the most intensive decrease in survival function was registered during the first 5 years of follow-up (5-year survival rate 60% [71%; 48%]. Carotid endarterectomy is an effective method of treating atherosclerotic stenosis of the ICA and a method of preventing neurological complications in patients with combined atherosclerotic lesions of the cerebral and coronary arteries with the progression of cardiac pathology. Реферат. Результати лікування хворих з поєднаними атеросклеротичними ураженнями церебральних та коронарних артерій, яким виконана каротидна ендартеректомія в різні строки перед аорто-коронарним шунтуванням. Григорук С.П., Зорін М.О., Дудукіна С.О. Якість життя пацієнтів після проведених оперативних втручань у пацієнтів з поєдн...

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Objective – to find out the causes of adverse effects of microsurgical exclusion of arterial aneurysms during the acute rupture period.Materials and methods. The results of 41 microsurgical exclusions of arterial aneurysms in the first two days after the rupture were analyzed. There were 17 men and 24 women. The age of patients was from 32 to 78 years, the average age was 50 years. Neurological status, the severity of the Hunt–Hess condition, and the level of consciousness on the Glasgow com scale were assessed. The Glasgow Scale was used to evaluate the quality of life of surviving patients.Results. After surgery, 12 (29.2 %) patients died. A statistically significant dependence of mortality have been established by the Hunt–Hess scale, the level of consciousness on the Glasgow scale, the prevalence of angiospasm according to cerebral angiography and the presence of ischemia according to spiral computed tomography. The severity of subarachnoid hemorrhage according to Fisher and angiospasm according to transcranial dopplerography, although they affect the mortality and outcome of surgery, but not statistically significant.Conclusion. Given the high mortality rate after microsurgical operations in the acute period of arterial aneurysms rupture the indications for their conduct should be more balanced. It should be taken into account the presence of adverse predictors.