Successful hybrid treatment of ruptured thoracic aortic aneurysm in senile female
Imaev T.E., Komlev A.E., Kabardieva M.R., Lepilin P.M., Shariya M.A., Kolegaev A.S., Medvedeva I.S., Galyautdinov D.M., Partigulov S.A., Ternovoy S.K., Akchurin R.S.
| Purpose. To assess the role of modern imaging techniques in the planning and implementa-tion of hybrid interventions for an aortic arch aneurysm in an elderly patient with a bur-dened comorbid background. Materials and methods. Hybrid intervention in patient, 80 years, with acute rupture of the thoracic aorta was performed - аortic arch endografting from the level of the brachioce-phalic trunk with endoprosthesis Zenit Alpha endoprosthesis with simultaneous “chimney” stent-graft Advanta V12 implantation in left common carotid artery and left-side carotid-subclavian bypass with Gore-Tex 6 mm prosthesis. Results. A female of 80 years with acute rupture of the thoracic aorta, massive right-side hemothorax has been successfully treated with hybrid intervention - endoprosthetics of the aorta with a subclavian left subclavian shunt. On the second day after procedure the pa-tient underwent puncture of the right pleural cavity with subsequent drainage because of persisting respiratory failure. On the fourth day the patient was transferred from intensive care unit in stable condition, on the twelfth day the patient was discharged on postoperative day 12. Multislice computed tomography (MSCT) is commonly used for diagnosis of acute aor-tic pathology and planning the optimal method of surgical treatment, as it allows to obtain detailed images of the entire aorta and surrounding anatomical structures, three-dimensional reconstructions of blood vessels, to give an accurate assessment of the morpho-logical characteristics of the aneurysmal sac, proximal and distal neck, degree of calcification and parietal thrombus, localization and extent of aortic wall defect. Conclusion. The use of new methods of endovascular and hybrid surgery in the treatment of aortic rupture of thoracic aortic aneurysms makes it possible to achieve clinical success even in extremely severe patients of elderly and senile age. The leading role in the planning of these operations belongs to actual imaging methods, primarily MSCT. |
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Keywords: aortic aneurysm rupture, multislice computed tomography, hybrid surgery.
Corresponding author: Imaev T. E.; e-mail: Этот e-mail адрес защищен от спам-ботов, для его просмотра у Вас должен быть включен Javascript
For citation: Imaev T.E., Komlev A.E., Kabardieva M.R., Lepilin P.M., Shariya M.A., Ko-legaev A.S., Medvedeva I.S., Galyautdinov D.M., Partigulov S.A., Ternovoy S.K., Akchurin R.S. Successful hybrid treatment of ruptured thoracic aortic aneurysm in senile female. REJR 2018; 8 (3):287-295. DOI:10.21569/2222-7415-2018-8-3-287-295.
Received:16.06.18Accepted:06.07.18