DIAGNOSIS AND INTERVENTIONAL TREATMENT OF CAROTID PATHOLOGY. A BRIEF HISTORICAL EXCURSION. FEATURES OF INTERVENTIONAL BENEFITS FOR COMBINED CAROTID AND CARDIAC PATHOLOGIES

Yuldashev Faridun Sh., Petrosyan Karen V., Dadabaev Gulamzhan M., Suladze Vladimir G.

The presented review systematizes the historical aspects of invasive treatment of obstructive lesions of the carotid arteries, starting from the earliest mentions in ancient Greek mythology and ending with modern interventional technologies. Detailed consideration is given to methods for diagnosing internal carotid artery stenosis, such as duplex scanning, CT angiography, MR angiography, and digital subtraction angiography, with their comparative analysis in patients with combined carotid and cardiac pathology. Special attention is paid to the evolution of surgical and endovascular techniques, including carotid endarterectomy and carotid artery stenting with various protective devices. A key section of this work is devoted to analyzing treatment strategies for patients with combined cardiac and carotid pathology. Based on data from international studies (SAPPHIRE, CREST, FRIENDS) and the clinical experience of domestic centers, the benefits and risks of single-stage, staged, and hybrid approaches in the treatment of these patients have been evaluated. The work emphasizes the lack of a unified strategy in the current literature and the need for an interdisciplinary approach in selecting the optimal treatment strategy for each category of patients.

Keywords:carotid stenosis, carotid endarterectomy, carotid artery stenting, combined carotid and cardiac pathology, hybrid treatment strategies