The literature data is presented covering epidemiological significance of acute cerebrovascular accidents (CVA) in‑ cidence in patients with brachiocephalic arteries lesion. The role of atherosclerotic lesion of carotid arteries in the develop‑ ment of ischemic cerebral stroke is shown. The basic methods for diagnosis of carotid arteries lesion has been analyzed as well as their availability and informative value. A comparative analysis of modern methods for surgical treatment of athero‑ sclerotic lesion of carotid arteries such as carotid endarterectomy (classic and eversion), endovascular procedure has been done. The main advantages and disadvantages of these treatment methods, indications and contraindications for their use are described. The timing of cerebral revascularization in the acute and delayed periods of ischemic stroke was estimated. The role of bilateral lesion of the carotid territory is shown as well as approaches to the treatment strategy of such patients.

The article presents a clinical case of endovascular treatment practice of a patient after carotid endarterectomy complicated by ischemic stroke. It is pointed out that early diagnosis allows well-timed detection of complications in the postoperative period and timely selection of treatment methods. The method of intravascular thromboectomy, which significantly reduces the onset of complications in the first hours after surgery, is described in detail. The tactics of management of patients with acute disorders of cerebral circulation during operations on brachiocephalic arteries are analyzed.