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The choice of treatment of carotid artery stenosis is firstly based on assessment of the degree of stenosis and embologeneity of the atherosclerotic plaque. But even in “good-risk” population it is still difficult to identify the patients who are particularly at high threat of stroke and would most benefit from carotid reconstruction. Along with common criteria numerous studies also focus on a prognostic role of a cerebrovascular reserve (CVR) and its state which allows to carry out more objective and pathogenetically substantiated selection of cases for surgical and medical treatment. The present study is a literature review of CVR assessment with different methods in relation to the clinical course of disease, severity of stenosis, the state of collateral circulation, its dynamics after operative procedures. Questions are discussed about the informative value of CVR indices in predicting ischemic strokes and postoperative hyperperfusion complications. It was concluded there is a great need for carrying out multicenter randomized studies to determine the prognostic role of CVR in the choice of treatment strategy, to clarify the indications and evaluate the effectiveness of surgical intervention in patients with stenotic lesions of the internal carotid arteries.

Predictive Value of Cerebrovascular Reserve in Patients with Carotid Artery Stenosis for Choosing Treatment Strategy