В подтверждение своей позиции цитаты из "Guidelines for the Prevention of Stroke in Patients With Stroke or Transient Ischemic Attack: A Guideline for Healthcare Professionals From АНА/ASA" (2011 год):
- Endovascular and surgical treatment of patients with extracranial vertebral stenosis may be considered when patients are having symptoms despite optimal medical treatment (including antithrombotics, statins, and relevant risk factor control) (Class IIb; Level of Evidence C)
- For patients with stroke or TIA due to 50% to 99% stenosis of a major intracranial artery, the usefulness of angioplasty and/or stent placement is unknown and is considered investigational (Class IIb; Level of Evidence C). (New recommendation)
- For patients with stroke or TIA due to 50% to 99% stenosis of a major intracranial artery, EC-IC bypass surgery is not recommended (Class III; Level of Evidence B). (New recommendation)
Что я расцениваю как следующую последовательность: вмешательство на позвоночных артериях возможно - польза ангиопластики интракраниальных артерий неизвестна - шунтирование не нужно.
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