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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">medalphabet</journal-id><journal-title-group><journal-title xml:lang="ru">Медицинский алфавит</journal-title><trans-title-group xml:lang="en"><trans-title>Medical alphabet</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2078-5631</issn><issn pub-type="epub">2949-2807</issn><publisher><publisher-name>ООО «Альфмед»</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.33667/2078-5631-2024-2-21-25</article-id><article-id custom-type="elpub" pub-id-type="custom">medalphabet-3613</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>Статьи</subject></subj-group></article-categories><title-group><article-title>Клинический случай этапной реперфузионной терапии при тяжелом ишемическом инсульте в бассейне левой внутренней сонной артерии на фоне диссекции</article-title><trans-title-group xml:lang="en"><trans-title>Clinical case of bridged reperfusion therapy in massive ischemic stroke in the territory of left internal carotid artery on the background of dissection</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-2421-2238</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Шарапова</surname><given-names>А. Л.</given-names></name><name name-style="western" xml:lang="en"><surname>Sharapova</surname><given-names>A. L.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Шарапова Анна Леонидовна - врач-невролог неврологического отделения.</p><p>Великий Новгород</p></bio><bio xml:lang="en"><p>Sharapova Anna L. - neurologist at Neurological Dept.</p><p>Velikiy Novgorod</p></bio><email xlink:type="simple">kra2453@yandex.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0007-2519-5325</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Ким</surname><given-names>Е. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Kim</surname><given-names>E. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Ким Евгений Васильевич - врач-рентгенохирург отделения рентгенохирургических методов диагностики и лечения.</p><p>Великий Новгород</p></bio><bio xml:lang="en"><p>Kim Evgeniy V. - X-ray surgeon at Dept of X-ray Surgical Methods of Diagnosis and Treatment.</p><p>Velikiy Novgorod</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-9245-8067</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Голдобин</surname><given-names>В. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Goldobin</surname><given-names>V. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Голдобин Виталий Витальевич - д.м.н., врач-невролог, заведующий кафедрой неврологии им. акад. С.Н. Давиденкова.</p><p>Санкт-Петербург</p></bio><bio xml:lang="en"><p>Goldobin Vitaly V. - DM Sci (habil.), neurologist, head of Dept of Neurology named after. n.a. academician S.N. Davidenkov.</p><p>Saint-Petersburg</p></bio><xref ref-type="aff" rid="aff-2"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>ГОБУЗ «Новгородская областная клиническая больница»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Novgorod Regional Clinical Hospital</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>ФГБОУ ВО «Северо-Западный государственный медицинский университет имени И.И. Мечникова» Минздрава России</institution><country>Россия</country></aff><aff xml:lang="en"><institution>North-Western State Medical University named after I.I. Mechnikov</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2024</year></pub-date><pub-date pub-type="epub"><day>27</day><month>04</month><year>2024</year></pub-date><volume>0</volume><issue>2</issue><issue-title>Неврология и психиатрия (1)</issue-title><fpage>21</fpage><lpage>25</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Шарапова А.Л., Ким Е.В., Голдобин В.В., 2024</copyright-statement><copyright-year>2024</copyright-year><copyright-holder xml:lang="ru">Шарапова А.Л., Ким Е.В., Голдобин В.В.</copyright-holder><copyright-holder xml:lang="en">Sharapova A.L., Kim E.V., Goldobin V.V.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.med-alphabet.com/jour/article/view/3613">https://www.med-alphabet.com/jour/article/view/3613</self-uri><abstract><p>Инсульт остается самой распространенной причиной смерти и стойкой нетрудоспособности в развитых странах мира. Одним из основных предикторов благоприятного исхода является максимально быстрая и безопасная реканализация окклюзированного сосуда головного мозга. За последние десятилетия эндоваскулярная терапия стала многообещающим терапевтическим подходом для пациентов с острым ишемическим инсультом при раннем использовании в диагностике инсульта методов нейровизуализации с высоким разрешением. Нами приводится клинический случай тяжелого ишемического инсульта вследствие окклюзии крупной артерии, подтвержденной с помощью компьютерно-томографической ангиографии. Показана эффективность реперфузионной терапии внутривенным введением альтеплазы в сочетании с тромбэктомией, также обсуждаются распространенные осложнения внутриартериальной реканализации. Раннее распознавание непредвиденных осложнений с последующим быстрым принятием решения по модификации тактики лечения во время этапной реперфузионной терапии имеют важное значение для улучшения результатов лечения.</p></abstract><trans-abstract xml:lang="en"><p>Stroke remains the most common cause of death and permanent disability in the developed countries of the world. One of the main predictors of a good outcome is both mostly fast and safety recanalization of the occluded vessel of the brain. Over the past decade, endovascular therapy became a promising therapeutic approach for patients with acute ischemic stroke in combination with early usage of high-resolution methods of neuroimaging. This article discusses a clinical case of severe ischemic stroke due to occlusion of a major artery, confirmed by CT angiography. The efficacy of reperfusion therapy with intravenous administration of alteplase in combination with thrombectomy was demonstrated, the most common intra-arterial recanalization complications were pointed out. The early recognition of sudden complications with rapid decision-making for therapy modification during bridged reperfusion therapy is important for improving results of trearment.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>острый ишемический инсульт</kwd><kwd>терапия острого инсульта</kwd><kwd>этапная реперфузионная терапия</kwd><kwd>тромболитическая терапия инсульта</kwd><kwd>осложнения эндоваскулярной механической тромбэктомии</kwd><kwd>эндоваскулярная механическая тромбэкстракция</kwd></kwd-group><kwd-group xml:lang="en"><kwd>acute ischemic stroke</kwd><kwd>acute stroke therapy</kwd><kwd>bridged reperfusion therapy</kwd><kwd>thrombolytic stroke therapy</kwd><kwd>endovascular mechanical thrombectomy</kwd><kwd>complications of endovascular mechanical thrombectomy</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Гусев Е. И., Скворцова В. И., Стаховская Л. В. 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