No multicenter randomized clinical trial has been conducted worldwide to date on indications, types of surgery and their comparison with conservative treatment in patients with PI BSA.Aims: of the study is to improve the results of surgical treatment in patients with pathological tortuosity of the internal carotid arteryMaterial and methods. Тhe study included 115 patients (38 (33%) men and 77 (67%) women) with PI ICA aged 35 to 72 years (average age 54.2 ± 7.5 years) divided into 2 groups. 61 patients (53%) of group I underwent BSA resection with lower mouth and 54 patients (47%) of group II underwent BSA prosthetics. Depending on the degree of neurological disorders, patients were distributed according to the classifi cation of A.V. Pokrovsky.Results. In patients with СМН1, the clinical eff ect was due to the absence of cerebrospinal and focal neurological symptoms. As a result of surgical treatment of PI BSA in group I, a clinical eff ect was achieved in 54 (89%) patients. In group II, regression of clinical-neurological symptoms was observed in 40 (74%) patients.Conclusions. Resection and prosthetics of BSA PI in order to stop neurological symptoms and prevent ischemic stroke in patients with this pathology is a safe and eff ective method of surgical treatment.

Goal. To analyze the evolution of the myocardial contraction force through the assessment of kinetic energy in patients with aortic stenosis based on intraventricular blood flowsMaterial and methods. According to the selection criteria, 21 healthy volunteers (age 34 ± 3) and 105 patients with aortic stenosis (age 62 ± 4) were examined before and after surgery for 7–10 days. Transthoracic echocardiography was performed on a Vivid E9 device in 2, 3 and 4 chamber positions with registration of intraventricular blood flows, calculation of the rate of change in volume and kinetic energy depending on the left ventricular EDV, pressure gradient (ΔP) on the aortic valve with an assessment of the displacement of the left ventricular endocardium contour, based on technologies for tracking speckles of ultrasonic images in the MultiVox program.Results. Our goal was to quantify kinetic energy (KE) during the entire cardiac cycle of the left ventricle (LV) using echocardiography. One of the main strengths identified in these studies is the high reproducibility of the assessment of LV blood flow and hemodynamics the average coefficient of variability 7 ± 2% for assessing LV function. Studies have shown increased diagnostic reliability without spending additional time. In systole, the KE before the LV operation was higher than normal values (0.62–0.78 J) after the operation, the KE approached the norm, averaging 0.55 J.Conclusion. Changes in intraventricular blood flow in patients with pressure overload of the heart demonstrate higher systolic energy compared to the control group. Different time values of energy in systole and diastole, observed in patients before surgery, represent an objective approach to assessing the work of the heart. The energy analysis reflects earlier signs of mechanical myocardial disorders, compared with the ejection fraction and, possibly, predict the development of cardiac remodeling. Adequate correction of the defect normalizes the work of the heart already in the early postoperative period.

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