New Potentialities in Surgical Treatment of Proximal Humerus

2011 ◽  
Vol 18 (1) ◽  
pp. 21-27
Author(s):  
Eduard Ivanovich Solod ◽  
A F Lazarev ◽  
Ya G Gudushauri ◽  
M G Kakabadze ◽  
A S Roskidaylo ◽  
...  
Keyword(s):  
Drug Therapy ◽  
Surgical Treatment ◽  
General Condition ◽  
Postoperative Period ◽  
Proximal Humerus ◽  
Original Method ◽  
Early Postoperative Period ◽  
Early Rehabilitation ◽  
Control Group ◽  
Stable Fixation

Original method of stressed osteosynthesis for the treatment of proximal humerus is proposed. Primary tension of Y-shaped pin fixative and secondary tension that is created at its intramedullar insertion and blocking enable to achieve stable fixation of fragments without inflicting additional intraoperative injury in patients of any age and independently of their general condition. Preservation of blood supple in fragments, low traumatic osteosynthesis, and possibility of patients' early rehabilitation define the prospective of this technique for the treatment of patients with fractures on the background of osteoporosis. The importance of drug therapy for osteoporosis in the early postoperative period is shown. Experience in treatment of 62 patients aged from 23 to 78 years is presented. Control group included 30 patients with similar fractures who were treated using osteosynthesis. In the main group good results were achieved in 82.3% of patients, satisfactory - in 17.7%, no poor results were observed. In control group good results made up 40%, satisfactory - 56.7%, poor 0 3.3%.

scholarly journals Neuropsychological features of patients of reproductive age diagnosed with breast cancer at the stage of surgical treatment using xenon-oxygen therapy

2021 ◽  
Vol 8 (3) ◽  
pp. 10-20
Author(s):  
D. A. Rozenko ◽  
A. I. Shikhlyarova ◽  
L. N. Vaschenko ◽  
N. N. Popova ◽  
Yu. Yu. Arapova ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Surgical Treatment ◽  
Postoperative Period ◽  
Oxygen Therapy ◽  
Early Postoperative Period ◽  
Reproductive Age ◽  
Control Group ◽  
Newly Diagnosed ◽  
Beta Rhythm ◽  
Psychophysiological State

Purpose of the study. To study functional changes in the neuropsychological status of reproductive age patients with newly diagnosed breast cancer and to assess the possibility of using xenon-oxygen therapy to correct disorders.Patients and methods. This study included 60 reproductive age patients with newly diagnosed breast cancer who were undergoing surgical treatment at the Department of Bone, Skin, Soft Tissue and Breast Tumors of the National Medical Research Centre for Oncology of the Ministry of Health of Russia from 2018 to 2020. The main group included 30 patients with breast cancer diagnosed at the surgical stage of combined treatment, who underwent a rehabilitation course of xenon-oxygen therapy in the early postoperative period. The control group was formed from patients with the same diagnosis, without the use of this therapy. The functional state of the central nervous system in all patients was assessed by the parameters of the electroencephalography (EEG) bioelectrical activity. For the final assessment of the physiological and psychological state of the patients, a standardized questionnaires of the quality of life – ESAS, MOS-SF‑36, were used. Statistical data processing was performed using the Statistica 10 software package. Results. During the study, statistically significant differences were found in the assessment of subjective indicators, so in the group of patients using xenon-oxygen therapy, there was an improvement in well-being by 2.6 times, a decrease in depression by 2.3 times, a decrease in symptoms of nausea by 3 times, anxiety 1.9 times (p < 0.05). Against the background of an improvement in the psychophysiological state, the EEG showed a significant increase in the power of slow delta and theta rhythms, an increase in the power of the alpha rhythm and a decrease in the power of the beta rhythm, while in the patients of the control group only a decrease in the power of the beta rhythm was noted.Conclusion. The early postoperative period in patients with newly diagnosed breast cancer is characterized by the formation of a depressive symptom complex. The use of a course of xenon-oxygen therapy contributes to the normalization of the subjective feeling of physical and psychological health, increasing vital and social activity. Changes in the indicators of brain bioelectric activity and an improvement in psychophysiological state occur against the background of changes in brain activity caused by the normalizing effect of xenon.

scholarly journals Minimum Invasive Stabilizing and Decompressive-Stabilizing Methods of Surgical Treatment for Degenerative-Dystrophic Lesions of Spine

2011 ◽  
Vol 18 (4) ◽  
pp. 3-10
Author(s):  
A V Krut'ko ◽  
Shamil' Al'firovich Akhmet'yanov ◽  
D M Kozlov ◽  
A V Peleganchuk ◽  
A V Bulatov ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Lumbar Spine ◽  
Surgical Techniques ◽  
Pain Syndrome ◽  
Early Postoperative Period ◽  
Main Group ◽  
Control Group ◽  
Surgical Interventions ◽  
Comparative Group ◽  
Operative Wound

Results of randomized prospective study with participation of 94 patients aged from 20 to 70 years with monosegmental lumbar spine lesions are presented. Minimum invasive surgical interventions were performed in 55 patients from the main group. Control group consisted of 39 patients in whom decompressive-stabilizing operations via conventional posteromedian approach with skeletization of posterior segments of vertebral column were performed. Average size of operative wound in open interventions more than 10 times exceeded that size in minimum invasive interventions and made up 484 ± 56 and 36 ± 12 sq.cm, respectively. Mean blood loss was 326.6 ± 278.0 ml in the main group and 855.1 ± 512.0 ml in the comparative one. In the main group no one patient required substitution hemotransfusion, while in 13 patients from the comparative group donor erythrocytic mass and/or fresh-frozen plasma were used to eliminate the deficit of blood components. Intensity of pain syndrome in the zone of surgical intervention by visual analog scale in the main group was lower than in comparative group. In the main and comparative groups the duration of hospitalization made up 6.1 ± 2.7 and 9.7 ± 3.7 bed days, respectively. In no one patient from the main group complications in the zone of operative wound were noted. Three patients from the comparative group required secondary debridement and in 1 patient early deep operative wound suppuration was observed. Application of low invasive surgical techniques for the treatment of patients with degenerative lumbar spine lesions enabled to perform radical surgical treatment with minimal iatrogenic injury. The method possessed indubitable advantages over the conventional open operations especially intraoperatively and in early postoperative period.

scholarly journals Changes in Indicators of Microcirculation in the Early Postoperative Period in the Treatment of Diaphyseal Fractures of the Shin Bones Using a Plate with Limited Contact

2019 ◽  
Vol 4 (3) ◽  
pp. 58-62
Author(s):  
A. I. Plakhov ◽  
L. I. Kolesnikova ◽  
L. I. Korytov ◽  
V. G. Vinogradov ◽  
M. A. Darenskaya
Keyword(s):  
Postoperative Period ◽  
Lower Limb ◽  
Blood Circulation ◽  
Early Period ◽  
Metal Plate ◽  
Early Postoperative Period ◽  
Control Group ◽  
Doppler Flowmetry ◽  
Results Of Treatment ◽  
Diaphyseal Fractures

Background. Unsatisfactory results of treatment, such as delayed consolidation and non-fusion of fractures, the formation of false joints and limb bone defects, have no tendency to decrease. We can assume that one of the leading factors of complications in traumatology is a violation of microcirculation in the affected segment of the limb.Aims. To identify patterns of changes in the parameters of the microcirculatory bed of the damaged segment of the lower limb when fixing bone fragments with a plate with limited contact in the early period after surgery.Materials and methods. In 25 patients, we studied four parameters of microcirculation of the lower limb segment with application of laser Doppler flowmetry. The control group consisted of 25 healthy volunteers, comparable in age and sex with the study group.Results. We found that in the early postoperative period (from the first to the 10th day after the surgery) in patients with diaphyseal fractures of the tibia operated with metal plate with limited contact there was an increase in microcirculation by 75.69 %, an increase in the proportion of the nutritive component of microcirculation compared to the shunt fraction by 24.64 %, as well as an increase in more than one ratio of the amplitude of the heart and respiratory range. All of that indicates a local circulatory disorder in the nutritive arterial hyperemia. We note that the increase in the amplitude of the respiratory component by 17.22 % and the equality of the amplitude of the cardiac range compared with the control group indicate violations of local blood circulation by the type of venous stagnation.Conclusion. On the basis of the results obtained, we note that patients with diaphyseal fractures of the shin bones treated with metal osteosynthesis with a plate with limited contact in the early postoperative period develop a violation of local blood circulation in the stagnant-hyperemic type.

scholarly journals ТREATMENT OF STENOSIS OF THE PYLORIC BULBAR ZONE OF ULCERATIVE GENESIS USING MINIMALLY INVASIVE SURGERY

2020 ◽  
pp. 167-175
Author(s):  
O. M. Babii ◽  
S. A. Tarabarov ◽  
N. V. Prolom ◽  
B. F. Shevchenko ◽  
A. A. Galinsky
Keyword(s):  
Surgical Treatment ◽  
Minimally Invasive ◽  
Postoperative Period ◽  
Clinical Signs ◽  
State Institution ◽  
Disease Recurrence ◽  
Control Group ◽  
Surgical Interventions ◽  
Remote Observation

Summary. Purpose: to improve the results of surgical treatment of stenosis of the pyloroduodenal zone of ulcerative origin through the use of minimally invasive laparoendoscopic interventions. Material and methods. In the Department of Surgery of the Digestive Organs of the State Institution “Institute of Gastroenterology of the NAMS of Ukraine” for 2014-2019, 114 patients with stenosis of the pyloroduodenal zone of ulcerative origin were examined. Of these, 35 — with compensated stenosis, 57 — with subcompensated, 22 — with decompensated stenosis. The average age (45.3±5.2) years. The control group consisted of 20 healthy individuals. All patients underwent surgical treatment using minimally invasive and traditional surgical interventions. Results and discussion. During the study, known indications were clarified and new indications for performing endoscopic balloon pyloroduodenoplasty and combined laparoendoscopic intervention were clarified. Complications in the immediate postoperative period occurred in 1 patient (1.04%) in the form of perforation of the dilated zone. In patients after the traditional laparotomy surgery, the average postoperative period was (15 ± 2) days. Complications in the immediate postoperative period occurred in 2 patients (11.1 %) in the form of bleeding and leaks in the pyloroplasty zone, which required repeated surgical treatment. Тhere were no fatal cases. The remote observation period was 7-22 months. Endoscopic, radiological and clinical signs of recurrence of peptic ulcer and stenosis were not detected. Conclusions. The method of minimally invasive endoscopic and combined laparoendoscopic interventions in the treatment of stenosis of the pyloroduodenal zone of ulcerative genesis is characterized by a minimal number of complications, has good efficacy indicators and the absence of disease recurrence in the long-term period.

scholarly journals The Effects of Vibration and Pressure Treatments in the Early Postoperative Period of Rhinoplasty

2019 ◽  
Vol 40 (6) ◽  
pp. 605-616 ◽  
Author(s):  
Süleyman Taş
Keyword(s):  
Postoperative Period ◽  
Early Postoperative Period ◽  
Control Group ◽  
Level Of Evidence ◽  
Vibration Treatment ◽  
The Face ◽  
Anti Inflammatory ◽  
Group 2 ◽  
A Prospective Study ◽  
Nasal Cast

Abstract Background The early postoperative period can be distressing for the patients undergoing rhinoplasty since edema and ecchymosis are common complications. Objectives To analyze the effects of the vibration and pressure treatments in the early postoperative period of rhinoplasty. Methods Sixty patients, who had undergone rhinoplasty, were randomized into 3 groups: group 1 (control group, n = 20) received classic nasal casting, group 2 (n = 20) received nasal cast with an elastic bandage to hold it on the face, and group 3 (n = 20) received vibration treatment in addition to that in group 2 following the rhinoplasty. They were evaluated preoperatively and postoperatively at 3 and 7 days in a prospective study. The postoperative edema and ecchymosis were scored by 2 independent surgeons. The postoperative pain was measured using the visual analog scale, and the necessity of anti-inflammatory medication (and the dose needed) and the cast comfort was questioned. The sebaceous activity of the nose skin was examined. A preoperative and postoperative seventh day sonographic study was performed to evaluate the tissue edema objectively. Results The pressure treatment decreased the edema and ecchymosis significantly compared with the control group. The vibration treatment minimized edema, ecchymosis, sebaceous activity of the nose skin, pain score, and the need for anti-inflammatory medication, and increased the cast comfort significantly compared with the other groups (P &lt; 0.0001). Conclusions Rapid regression of edema and ecchymosis may be achieved using the vibrating nasal cast technique that may minimize patient discomfort, pain, and sebaceous activity following rhinoplasty. Level of Evidence: 1

Seizures after evacuation of subdural hematomas: incidence, risk factors, and functional impact

2010 ◽  
Vol 112 (2) ◽  
pp. 455-460 ◽  
Author(s):  
Alejandro A. Rabinstein ◽  
Seung Young Chung ◽  
Leslie A. Rudzinski ◽  
Giuseppe Lanzino
Keyword(s):  
Surgical Treatment ◽  
Functional Outcome ◽  
Functional Impairment ◽  
Postoperative Period ◽  
Strong Association ◽  
Early Postoperative Period ◽  
Acute Subdural Hematoma ◽  
Early Functional Outcome ◽  
Gcs Score

Object The purpose of this study was to evaluate the incidence of seizures or epileptiform abnormalities on electroencephalography (EEG) studies in patients undergoing surgical treatment for acute subdural hematoma (SDH). Methods This was a retrospective study of 134 consecutive patients with acute or acute-on-chronic SDH who underwent surgical treatment at the authors' institution between January 2004 and July 2008. Detailed information was collected regarding baseline clinical data (including preexistent functional impairment); Glasgow Coma Scale (GCS) sum scores before and 24 hours after surgery; presence of clinical seizures; EEG findings; and functional outcome on discharge and up to the 6-month follow-up. All brain CT scans were reviewed to calculate SDH volume and midline shift. The Glasgow Outcome Scale (GOS) score was used for functional assessment, and GOS scores of 1–3 were considered indicative of poor outcome. Univariate and multivariate logistic regression analyses were performed to identify statistical associations. Results Clinical seizures or epileptiform changes on EEG were observed during the acute postoperative period in 33 patients (25%). Preexistent functional impairment and seizures/epileptiform EEG findings after surgery were independently associated with poor functional outcome upon hospital discharge (p < 0.001 for both). Preexistent functional impairment (p < 0.001), lower GCS score before surgery (p = 0.04), and lower GCS score 24 hours after surgery (p = 0.007), but not seizures/epileptiform EEG findings, were independently associated with poor functional recovery at 1- to 6-month follow-up evaluations. Seizures/epileptiform EEG findings had a strong association with lower GCS scores after surgery (p = 0.01), and they were more common in patients who underwent evacuation by craniotomy (p = 0.02). Conclusions Epileptic complications are common after acute SDH evacuation, and should be suspected in patients with an unanticipated depressed level of consciousness after surgery. Seizures worsen early functional outcome, but delayed favorable recovery is possible. Therefore, one should be cautious when discussing prognosis in the early postoperative period of patients with epileptic complications.

scholarly journals SURGICAL TREATMENT OF CAROTID STENOSIS IN PATIENTS WITH CORONARY HEAR+T DISEASE IN ORDER TO PREVENT ISCHEMIC STROKE

2020 ◽  
pp. 124-126
Author(s):  
I. S. Pulyaeva ◽  
V. A. Prasol
Keyword(s):  
Ischemic Stroke ◽  
Surgical Treatment ◽  
Carotid Stenosis ◽  
Postoperative Period ◽  
Stable State ◽  
Length Of Hospital Stay ◽  
Early Postoperative Period ◽  
Main Stage ◽  
Simultaneous Operations ◽  
Ischemic Attack

Summary. Goal. To analyze the results of surgical treatment of carotid stenosis in patients with coronary heart disease in order to prevent ischemic stroke. Materials and methods. The analysis included 18 patients treated in the SI «V. T. Zaitseva IGUS of NAMNU» from 2017 to 2019 in combined atherosclerotic lesions of the coronary and carotid arteries which evaluated the reserve brain. Results and discussion. All patients with two-stage treatment of the first and second groups were discharged in a stable state, one had a clinic of transient ischemic attack in the postoperative period. Conclusions. Simultaneous operations are advisable in patients with a reduced reserve of both coronary and cerebral circulation. The risk of developing cerebral and cardiac postoperative complications is comparable with the results of phased operations, reducing the length of hospital stay of the patient. The results of the hypoxic test serve as an additional criterion for the decision to impose an internal intra-arterial shunt. This allows you to reduce the time of the main stage of carotid endarterectomy and to avoid additional possible complications in the early postoperative period.

scholarly journals Anti-Vascular Endothelial Growth Factor Therapy as an Adjunct to Diabetic Vitrectomy

2021 ◽  
Vol 15 (1) ◽  
pp. 137-143
Author(s):  
Mushfig Karimov ◽  
Lala Akhundova
Keyword(s):  
Diabetic Retinopathy ◽  
Proliferative Diabetic Retinopathy ◽  
Postoperative Period ◽  
Early Postoperative Period ◽  
Vitreous Cavity ◽  
Control Group ◽  
Diabetic Vitrectomy ◽  
Clinically Significant ◽  
Bevacizumab Injection

Introduction: The purpose of this work is to study the efficacy of the preoperative intravitreal administration of bevacizumab as an adjunct to vitrectomy in patients with Proliferative Diabetic Retinopathy (PDR). Methods: This retrospective comparative study was performed on 118 eyes (118 patients) with proliferative diabetic retinopathy (PDR), which underwent vitrectomy surgery at the Department of Diabetic Eye Disease at Zarifa Aliyeva National Ophthalmology Centre (Baku, Azerbaijan) in 2015-2019. The main group (the bevacizumab group) included 48 eyes with PDR that received intravitreal administration of bevacizumab (Avastin; Genentech Inc., USA) within one week before vitrectomy; the control group included 70 eyes that did not receive a bevacizumab injection for at least 3 months before the vitrectomy. The minimum follow-up was 12 months. Results: In both groups, complete retinal attachment after primary vitrectomy was achieved in all eyes (100%). Clinically significant intraoperative haemorrhage was observed in the preoperative bevacizumab injection group in 31.2% and the control group- 51.4%, p = 0.030. The preoperative bevacizumab injection reduced the risk of clinically significant haemorrhage by 2.3 times and the need for endodiathermy by 2.7 times (p = 0.031 and p = 0.024, respectively). Early vitreous cavity haemorrhage was observed in 15.0% in the bevacizumab group and in 35.5% in the control group (p = 0.038). The preoperative injection of bevacizumab before vitrectomy reduced the risk of vitreous cavity haemorrhage in the early postoperative period by 3.0 times (p = 0.036). Conclusion: The preoperative use of bevacizumab as an adjunct to diabetic vitrectomy can help reduce the incidence of intraoperative and early postoperative vitreous cavity haemorrhage, which leads to better functional results in the early postoperative period. Over the long-term follow-up period, the effect of the preoperative bevacizumab injections decreases.

scholarly journals PREVENTIVE COLOSTOMY IN PLANNED TREATMENT OF PATIENTS WITH RECTAL CANCER

2015 ◽  
Vol 174 (4) ◽  
pp. 24-29 ◽  
Author(s):  
N. A. Maistrenko ◽  
A. A. Khvatov ◽  
A. A. Sazonov ◽  
S. N. Petrov
Keyword(s):  
Rectal Cancer ◽  
Postoperative Period ◽  
Original Method ◽  
Early Postoperative Period

The article described an original method of forming preventive colostomy, which reduced the rate of incompetence of interintestinal anastomosis in sphinctersaving resection concerning rectal cancer. This also facilitated patient’s rehabilitation in early postoperative period.

scholarly journals Brachicefalinių arterijų chirurginės korekcijos rezultatai

2003 ◽  
Vol 1 (4) ◽  
pp. 0-0
Author(s):  
Ilona Bičkuvienė
Keyword(s):  
Health Status ◽  
Surgical Treatment ◽  
Conservative Treatment ◽  
Postoperative Period ◽  
Clinical Symptoms ◽  
Neurological Symptoms ◽  
Surgical Correction ◽  
Control Group ◽  
Combined Lesions ◽  
Brachiocephalic Arteries

Ilona BičkuvienėVilniaus universiteto Neurologijos ir neurochirurgijos klinikaVilniaus greitosios pagalbos universitetinės ligoninėsNeuroangiochirurgijos centrasŠiltnamių g. 29, LT-2043 Vilnius Įvadas / tikslas Įvertinti vertebrobazilinės ligos klinikinę raišką ligoniams, kuriems yra įvairi brachicefalinių arterijų patologija, iki ir po šių arterijų rekonstrukcijos. Ligoniai ir metodai Ištirti 288 ligoniai, kuriems pasireiškė vertebrobazilinės ligos klinikiniai simptomai ir įvairi brachicefalinių arterijų patologija. Chirurgiškai gydyti 228 ligoniai, o konservatyviai – 60 ligonių, kurie sudarė kontrolinę grupę. Visi ligoniai ištirti neurologo, jiems atliktas brachicefalinių arterijų dvigubas skenavimas ir aortos lanko šakų angiografija. Operuotų arterijų neurologiniai klinikiniai pokyčiai ir kraujotaka buvo vertinama per 3 metų laikotarpį. Rezultatai Paroksizmai yra būdingi neurologiniai simptomai esant brachicefalinių arterijų patologijai. Šių arterijų chirurginė korekcija atliekama, jei konservatyvus gydymas buvo neveiksmingas, o neurologinė simptomatika progresavo. Chirurginiam gydymui įvertinti ligoniai tirti po operacijos praėjus ne daugiau kaip 2 savaitėms, iki 1 metų ir nuo 1 iki 3 metų. Pagrindinis dėmesys buvo sutelktas į neurologinių simptomų pokyčius trečiuoju pooperaciniu laikotarpiu. Teigiami klinikiniai pokyčiai (paroksizmai po operacijos visiškai nebesikartojo) nustatyti daugiausia tiems ligoniams, kuriems buvo brachicefalinių arterijų anomalijos (82,86%) ir deformacijos (72,54%). Chirurginis gydymas buvo neveiksmingas 30% ligonių, kuriems yra brachicefalinių arterijų ateroskleroze, ir 21% – mišri patologija. Papildomų simptomų, kurių iki operacijos nebuvo, atsirado mišrios patologijos grupės ligoniams (3,41%). Chirurginio gydymo veiksmingumui įrodyti ištirta 60 kontrolinės grupės ligonių. Teigiamų sveikatos būklės pokyčių nenustatyta. Ketvirtadalio ligonių sveikatos būklė nepakito, kitų – pablogėjo dėl naujų praeinančių smegenų išemijos priepuolių ir insultų. Išvados Teigiami pooperaciniai pokyčiai per trejų metų laikotarpį leidžia teigti, jog subjektyvūs ir objektyvūs neurologinai vertebrobazilinės ligos simptomai siejasi su įvairia brachicefalinių arterijų patologija. Tais atvejais, kai konservatyvus gydymas neveiksmingas, galima chirurginė brachicefalinių arterijų korekcija. Prasminai žodžiai: brachicefalinės arterijos, vertebrobazilinė liga, chirurginis gydymas, pooperaciniai rezultatai Vertebrobasilar disease. Results of surgical correction of brachiocephalic arteries Ilona Bičkuvienė Background / objective The aim of this study was to analyze preoperative and 3-year follow-up postoperative symptoms of vertebrobasilar disease due to the pathology of brachiocephalic arteries. Methods 288 patients with symptoms of vertebrobasilar disease due to the pathology of brachiocephalic arteries have been examined. 228 patients were operated on and 60 (control group) were treated conservatively. All the patients were examined by the neurologist, duplex scanner and angiographycally. Neurological clinical dynamics and blood flow in operated on arteries were evaluated in a 3-year period. Results Paroxysms are characteristic of the lesions of the brachiocephalic arteries. Surgical correction of the lesions was performed if the conservative treatment had no effect and the neurological symptoms were progressing. To evaluate the effectiveness of surgical treatment, the patients were examined in the early postoperative (2 weeks after operation) and late postoperative period: 1) until 1 year and 2) from 1 to 3 years. Attention was focused on the dynamics of the neurological symptoms in the third postoperative period (from 1 to 3 years). Positive clinical dynamics (paroxysms disappeared) was ascertained mostly in the groups with anomalies of the brachiocephalic arteries (82.86%) and deformations (72.54%). This surgical treatment was ineffective in 30% of cases in the group with atherosclerotic and in 21% with combined lesions of brachiocephalic arteries. New additional symptoms after operation were ascertained in the group with combined lesions (3,41%). To approve the effectiveness of surgical treatment, 60 patients (control group) were examined. They had been treated conservatively, without a positive dynamics of their health status. There were no changes in the health status for the quarter of the patients. In all the others the health status worsened – TIA and strokes appeared. Conclusions A 3-year positive postoperative dynamics allow us to conclude that the subjective and objective clinical symptoms are connected with various types of pathology of brachiocephalic arteries. In cases when conservative treatment is unsuccessful, surgical treatment of brachiocephalic arteries can be applied. Keywords: brachiocephalic arteries, vertebrobasilar disease, surgical treatment, postoperative results

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