SU1680097A1 - Method for installing prosthesis of renal artery - Google Patents

Abstract

The invention relates to medicine, namely to vascular surgery, and can be used in prosthetics of the renal artery. The purpose of the invention is to prevent the occurrence of prosthetic aneurysm by increasing the strength of the wall of the prosthesis and the anastomosis sites. They take an autovene 2.5–3 times the length of the affected part of the artery, make two segments of it, one of which is longer than the other in a ratio of 3: 4, anastomose the short section of the autogenous with the distal segment. The renal artery, pull the long uastok on it the autowenes, turned intima outward, then impose a second proximal anastomosis and cover the transplant and the anastomotic zones with a long section of the autonix, and fix it. The method allows to reduce the number of postoperative complications by achieving a stiffness of the graft of the prosthetic renal artery and covering the anastomosis sites. The method is recommended for use in the clinic. (L

Description

The invention relates to medicine, namely to vascular surgery, and can be used in renal artery prosthetics.

The purpose of the invention is to prevent the occurrence of prosthetic aneurysms by increasing the strength of the prosthetic wall and anastomosis sites.

The method is carried out as follows.

From the great saphenous vein of the thigh, a graft is taken 2.5–3 times the length of the defect. Divided into two segments in the ratio of 3: 4. After lateral pressing of the renal aorta and squeezing of the branches of the renal artery, resection of the altered area of the vessel is performed. A short stretch of autovenes anastomose with

distal segment of the renal artery. At the other end of the graft impose a thread - taped, with which a long section of the autowen is held on the prosthesis. The proximal anastomosis of the short section of the autovena is applied with the end to the end of the renal artery or the end of the aorta to the side. An autovenous duplicator is formed by covering the graft and the anastomosis zone with a long autoven area, followed by fixing it to the artery auto ventilation behind the anastomosis line. Remove the clamps, restore the blood flow.

Example. The patient, 29 years old, was admitted to the clinic with complaints of recurring headaches, palpitations, increased fatigue. He is sick from the age of 11,

about

00 Oh

about h vj

when an elevated blood pressure was first noted, which subsequently gradually increased. From the age of 27, blood pressure stabilized in the figures of 180-200 / 110-120 mm at. St, antihypertensive therapy gave a short-term effect. Conducted clinical and radiological examination.

Abdominal aortography: right renal artery without pathology, left renal artery stenosed circularly in the middle and distal segment up to 80% over 26 mm to the border of the division into branches.

Clinical diagnosis: fibromuscule p-pa dysplasi of the left renal artery, tubular form, vasorenal hypertension. An autovenous duplication prosthesis of the left renal artery was performed.

Thoracophrenolumbotomy: in the ninth interstitial region, the peritoneal space was extraperitoneally allocated. Left kidney 12 x 6 cm bean-shaped. Produced by a twist. The left renal artery in the middle and dysgal segment is tight, does not pulsate. Lateral depression of the renal aorta is performed laterally, vascular clamps are applied to the branches of the renal artery. The renal artery has been resected during 26 mm. From the great saphenous vein of the femur two sites were prepared in length in the ratio of 3: 4, the short segment of autorenes was marked with a distal segment of renal i. arteries. With the help of the thread-holder for the graft, another long section of autowen was held. A proximal anastomosis of the renal artery with a short autovene area was superimposed. An autovenous duplicator was formed by covering the graft and the anastomosis zone with a long autovene section, followed by fixation of it to the adventitia of the artery behind the anastomotic line. After the clamps were removed, the blood flow was restored, there was no bleeding from the anastomoses zones. The autovenous graft is geometrically consistent with the renal artery. Drainage of the pleural cavity and retroperitoneal space, layer-by-layer suture of the wound. There were no complications in the immediate postoperative period, normalization of blood pressure occurred. Discharged home in satisfactory condition.

The proposed method of prosthetic renal artery can be used in vascular surgery for the surgical treatment of stenotic lesions of the renal artery in cases where there are doubts about the strength properties of the great saphenous vein used as a graft.

Claims (1)

DETAILED DESCRIPTION OF THE INVENTION Claim for prosthetics of the renal artery, including the use of autovenes, characterized in that, in order to prevent the occurrence of prosthetic aneurysm by increasing the strength of the prosthetic wall and anastomosis sites, the autovene segment is taken with a size that allows replacing the defect with a double autovenous insert, while the outer segment of autovenous invert invert outside and cover them with the place of anastomoses of the inner segment.