Dissection of brachiocephalic and intracranial arteries is the leading cause of ischemic stroke at a young age. It is a rupture of the intima of the artery with the formation of an intrahepatic (intramural) hematoma, leading to stenosis and / or occlusion of its lumen with a high probability of acute ischemic stroke developing. The epidemiology, etiology, pathogenesis, and clinical picture of brachiocephalic and intracranial artery dissection are described in the scientific work. The article presents the modern principles of treatment of this pathology.

In patients undergoing surgical treatment of aortic heart defects under artificial circulation, pre-operative correction of serum iron levels, and application of blood-saving techniques during surgery reduce the level of postoperative anemia. The aim. To investigate the combined influence of preoperative correction of serum iron levels and blood-saving techniques in the early postoperative anemia in the surgical treatment of aortic heart defects under artificial circulation. Material and methods. This study involves 133 patients with acquired aortic heart diseases undergoing surgical treatment under artificial circulation and aims at identifying the combined effect of preoperative correction of serum iron (III) hydroxide levels and blood-saving techniques on the level of postoperative anemia. The levels of iron, transport enzymes, blood corpuscles, Hb and Ht were investigated. All the patients were divided into 3 groups. Group A (control group) included 52 patients in whom iron levels were within the normal range and donated blood components were used during the intervention. Group B (study group) included 43 patients in whom iron levels were within the normal range and blood-saving techniques were used during the intervention. Group C (adjustment group) included 38 patients with low iron levels and anemia, which was interpreted as anemia of chronic disease (ACD). Preoperative correction of serum iron levels and intraoperative blood-saving techniques were applied in this group. Results. For the purpose of perioperative anemia correction, transfusion of 539.8 ± 9.1 ml (p¤0.05) of packed red blood cells and 582.4 ± 77.2 ml (p¤0.05) of fresh frozen plasma was given in Group A patients. In the Group B, the use of blood-saving techniques during the intervention allowed us to obtain good clinical effect without perioperative transfusion of blood products. It was established that in Group C preoperative correction of serum iron enabled to achieve 5.6 times higher level of serum iron (p¤0.05), 2 times higher transferrin saturation, and 7.3 times higher ferritin activity (p¤0.05), as well as increase preoperative Hb level by 9.5 % and decrease postoperative anemia by 8.7 %. Conclusions. Correction of low baseline serum iron in patients with chronic anemia (ACD) provides 5.6 times increase in preoperative serum iron (SI) (p¤0.05), increases hemoglobin by 9.5% (p¤0.05), and reduces the level of postoperative anemia in patients undergoing surgical treatment of aortic heart defects under artificial circulation with the use of blood-saving techniques and without the use of donor blood and Cell Saver.

In December 2019, an outbreak of pneumonia caused by a novel coronavirus occurred in Wuhan, Hubei province, spreading rapidly first throughout China and subsequently across Europe, the United States (US), and the rest of the world. On January 30, 2020, the World Health Organization (WHO) declared the COVID-19 outbreak a public health emergency of international concern, and on March 12, 2020, it was characterized as a pandemic. Patients exposed to this virus named as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) frequently present with fever, cough, and shortness of breath within 2 to 14 days after exposure, and then usually develop coronavirus disease (COVID-19)-related pneumonia. Although respiratory symptoms prevail among all clinical manifestations of COVID-19, preliminary studies showed that some patients may develop severe cardiovascular (CV) damage. To date, the COVID-19 pandemic has caused significant changes in the prevalence and pathogenesis of cardiovascular diseases among the population in Ukraine and other countries and has led to a significant increase in mortality in this category of patients. These changes necessitated adjustment of drug treatment in patients with concomitant COVID-19. Conclusions. COVID-19 is a global pandemic with unpredictable consequences due to mutually reinforcing damage to the respiratory and cardiovascular systems. Treatment of acute coronary syndrome on the background of COVID-19 requires a systematic approach involving physicians of various specialties as well as compliance with anti-epidemic mea- sures. Interventional treatment is quite effective in treating patients with COVID-associated acute coronary syndrome. COVID-19 patients on mechanical ventilation should use intravenous P2Y12 receptor blockers or drugs that can be crushed and administered through a nasogastric tube. Cangrelor, an intravenous P2Y12 receptor blocker with fast action and high controllability, enabled to achieve the optimal result of the intervention.