[Surgical treatment and interventional therapy in cerebral ischemia]

The aim of this review was to evaluate the possibility of correcting cerebral ischemia (including both extracranial varieties) using elective as well as emergency surgery in order to avoid the onset of acute cerebral ischemia. The study included patients suffering from cerebral ischemia with a thromboembolic etiology. The author describe the emergency surgical procedures currently used in embolic forms affecting the extracranial vessels and percutaneous transluminal angioplasty (PTA) which is confined solely to extracranial vessels at present. In the authors' opinion, this method (with or without the application of one or more stents) will soon represent the routine method of cerebral revascularisation in the near future. The authors review the results currently obtained using extracranial PTA in the main brain surgery centres worldwide, the most frequent complications and the problems still to be resolved. In conclusion, it is useful to use interventional procedures to treat both extracranial and intracranial lesions in order to significantly reduce mortality from acute cerebral ischemia and its functional sequelae.