[Hibrid intervention for internal carotid artery stenosis and ipsilateral aneurysm of anterior communicating artery]

The presence of an ipsilateral aneurysm in stenosis of the internal carotid artery is determined by the findings of CT angiography in 1.8-3.2% of cases. The available literature has described a wide variety of treatment for this pathology: isolated or alternate, with a method of simultaneous endovascular treatment, i. e., carotid stenting and endovascular embolization of an aneurysm, currently gaining popularity. The major difficulties associated with therapeutic decision-making in this cohort of patients include stage-wise nature, temporal parameters, the need for removal of an intracranial aneurysm, and assessment of perioperative complications. A clinical case report presented herein is an example of a method of a hybrid approach, i. e., simultaneously performing carotid endarterectomy and endovascular embolization of an aneurysm. In certain cases (anatomical variants, structure of an atherosclerotic plaque, individual peculiarities), this approach is more justified than popularity-gaining simultaneous endovascular treatment.