SU1066564A1 - Method of treatment of congenital arteriovenous dysplasia - Google Patents

Abstract

METHOD OF TREATMENT OF CONGENITAL ARTERIO-VENOUS. Dysplasia, including arrest of the main blood flow in the affection vessel and its branches x, followed by excision of angiodysplasias, characterized in that, in order to reduce the amount of suboperative blood loss, arrest of the main blood flow is performed by selective suboperative embolization of the branches of the adrenal vessel followed by resection life.

Description

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This invention relates to medicine, namely to vascular surgery.

There is a known method for the treatment of congenital arterio-ve1: Ozny dysplasias, including arrest of the main blood flow in the resulting vessel and its branches, followed by excision of angiodysplasias J.

However, excision of angiodysplasia is accompanied by massive, sometimes life-threatening, suboperative blood loss.

The aim of the invention is to reduce the amount of suboperative blood loss.

The goal is achieved by the method of treating congenital arterio-venous dysplasia, including arrest of the main blood flow in the leading vessel and its branches, followed by excision of angiodysplastic, and stopping the main blood flow to it by means of selective suboperative embolization of the branches of the leading vessel with its subsequent resection ia over time.

The method is carried out as follows.

Depending on the area of intervention, surgical access is used to isolate and take the supports of the tripartite artery and the head sections of its branches. With the help of an injection needle, the diameter of which is picked up depending on: - on the diameter of the vessel, puncture of the leading vessel is performed.

An embolisapia device is attached to the needle, the reservoir of which is pre-filled with an embolizing agent. As an embolism substance polystyrene spherical 4yurmy, activated carbon is used. The diameter of the particles is 0.2-0.6 mm. With the help of a syringe, an overpressure is created in the reservoir of the device, as a result of which the embolizing substance enters one of the branches of the driving vessel. At the time, initial sections of the other branches are clamped to block the blood flow through them. The absence of retrograde blood flow from this branch or the absence of contrasting of the vessel in suboperative arteriography is considered a sign of complete embolization of the vessel. In this case, the embolized branch is tied at the place of origin of the silk ligature from the driving vessel. After that, other branches are embolized in the same sequence. Those branches, which, according to arteriography, are not involved in the pathological process, are not embolysis: they are laid, but tied with a silk ligature in the place of divergence from the leading vessel. Then, resection of the vessel with the vessel is performed during a dedicated area with its flashing at the place of discharge from the main main artery of the prox. at the level of the initial divisions of the branches of the adductor vessel, it is distal. By resection (nn ()) of the trunk of the donating vessel, in addition to stopping. their.

Example. Ill L. 26 years. I went to the clinic with complaints of an increase in

About the volume of the right Yagodina with the presence of a dark-cherry spot in the upper-outer quadrant of it, varicose veins and pulsating veins in the spot area. The phonography determines systolic-diastolic murmur on the iliac vessels to the right. According to arteriography, the expansion of the main trunk of the internal iliac artery and its branches, the positive symptom of the early segmental contour of the internal iliac vein, and the accumulation of contrast in the upper outer quadrant of the right lidius are determined.

Under the general anesthesia with zakryupshnny access according to Pirogov on the right, the common, external and internal iliac artery and the initial sections of its branches are isolated. The internal idiopathic artery is dilated, its wall is thinned. A puncture was performed with an injection needle to which an embolization device was attached. The vascular clamps are applied to the initial sections of the inner lumen of the iliac artery, with the exception of the upper annual artery, to stop the flow of blood. Using a syringe to create an overpressure in the reservoir of the embolization device, embolization of the upper annual artery is performed, first with polystyrene emboli, and then emboli. From a preserved cartilage. Embolization of the upper annual arterin is stopped in the absence of retrograde blood flow from it and in the absence of ContraO; tirovaniya last on the whole control suboperative arteriography. Upper annual artery at the site from walking from the main trunk of the inner. ileal artery is tied up with silk ligature. Then the clamp is removed from the lower annual artery and embolization is performed in the same sequence. The artery is ligated with silk ligature at the site of discharge from the internal iliac artery. The remaining branches of the inner

0 ileal artery is ligated at the place of discharge by silk ligature. Resection of the main trunk of the internal iliac artery is performed throughout the selected area with its flashing at the place of origin from the common elevation of the artery.

5 proximally, n. level of primary departments. branches of the internal iliac artery: distal. Careful hemostasis. After surgery, the wound is washed with antibiotics34

TICKS and sutured in layers. Impose the proposed method allows reduction. Total blood loss over a period of one-sew 200 ml of suboperative blood loss, which did not require a 2-fold excision of angiodysplasia, nor blood loss. Postoperative peri-Complications associated with the use of Danod proceeded smoothly. Not noted.

1066564

Claims (1)

METHOD FOR TREATING CONGENITAL ARTERIO-VENOUS. DYSPLASIA, including stopping the main blood flow in the adducting vessel and its branches, followed by excision of angio dysplasias, characterized in that, in order to reduce the magnitude of suboperative blood loss, the stopping of main blood flow is performed by selective suboperative embolization of the branches of the adducting vessel with its subsequent resection. (L © © © ΟΊ © 4 ^ 1066564.