Hybrid intervention in a patient with tandem proximal-distal lesion of the internal carotid artery in acute ischemic stroke

RELEVANCE. Pathological tortuosity of the carotid artery and thrombotic occlusion of the intracranial segment of the carotid artery, critical subostial stenosis are the main causes of tandem lesions in patients with intracranial cerebral artery occlusion. Proximal occlusion may prevent intracranial endovascular access to distal tandem occlusion and increase the risk of endovascular complications. The OBJECTIVE was to evaluate technical and functional results of the hybrid technologies used in treatment of a patient with tandem damage of proximal and distal segments of the carotid basin in the acute period of ischemic stroke. CLINICAL OBSERVATION. The result of the intervention was a change in stroke severity by comparing scores on the national Institutes of Health Stroke Scale (nIHSS) after a hybrid intervention – primary reconstruction of the left internal carotid artery with pronounced pathological tortuosity in the extracranial segment and thrombectomy from the tandem M1 occlusion of the left medial artery segment in a patient with ischemic stroke in the left carotid pool in the acute period. A rare clinical observation is presented.