SU1690708A1 - Method for surgical treatment of aneurysms of the abdominal aorta - Google Patents

Abstract

This invention relates to vascular surgery and may be used in the surgical treatment of abdominal aortic aneurysm. The goal is to reduce the trauma by reducing the time to restore blood flow in the distal regions from the aneurysm. After the aneurysm is turned off from the bloodstream, an anastomosis is first formed between the common iliac arteries, then an extraanatomic one-way linear subclavian-femoral bypass is performed, and the main blood flow is restored in the arteries of the pelvis and lower extremities. The method makes it possible to reduce the number of anastomoses applied. The method is recommended in practical health care.

Description

This invention relates to vascular surgery and may be used in the surgical treatment of abdominal aortic aneurysms.

The purpose of the invention is to reduce trauma by reducing the time of the operation.

The method is carried out as follows.

After exposure of the aortic-iliac segment, the aneurysm is turned off from the bloodstream. For this, proximal to the localization of the aneurysmal process block the blood flow in the abdominal aorta. Then, depending on the length of the aneurysmal process between the two clamps, the common iliac arteries cross. After that, proximal sections of both iliac arteries are ligated, and their distal sections anastomose with each other in an end-to-end type. At the final stage of the operation, an extraanatomic one-way linear subcranial-femoral shunting is performed and

restore the main blood flow in the arteries of the pelvis and lower extremities. At the same time, the blood flow in the arteries of the lower extremity on the side of the location of the extraanatomical shunt is antegrade in nature, and in the iliac arteries on both sides and the arteries of the opposite lower limb - retrograde.

When implementing this method, impose three anastomosis and eliminates the need for exposure of the femoral arteries on one side.

Example. Patient S., 66 years old, was admitted to the vascular surgery department with a diagnosis of aneurysm of the infrarenal abdominal aorta. From the left extraperitoneal access to the left, the aortic-iliac segment was isolated. The revision found that the abdominal aortic aneurysm begins immediately below the level of the discharge of the renal arteries, and therefore the proximal anastomosis could not be performed during direct reconstruction. Therefore, on the neck

with about VI

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aneurysm directly under the renal arteries to block blood flow along the aortoiliac segment, a clip is applied. The common iliac arteries down from the aneurysm within the unchanged vessel walls are crossed between two clamps. The proximal portions of both iliac arteries are ligated twice with flashing. Then between the distal parts of the common iliac arteries an anastomosis of an end-to-end type is formed. After that, an extraanatomic unilateral linear subclavicular-femoral shunting was performed on the right and the organs of the pelvis and lower extremities were included in the main blood flow.

Upon completion of the operation, a clear pulsation was detected in the arteries of all segments of both lower extremities. The postoperative period was uneventful, the patient was discharged with clinical recovery.

Thus, the proposed method of surgical treatment of abdominal aortic aneurysm allows increasing the operability of patients, reducing

the duration and trauma of the operation, the likelihood of specific complications.

The method is recommended for use in vascular surgery.

For rmal a and goiter n and

A method of surgical treatment of abdominal aortic aneurysms, including switching off the aneurysm from the bloodstream, sequential imposition of shunts between both femoral and right subclavian and femoral arteries, characterized in that, in order to reduce the incidence of surgery by shortening the operation time, the aneurysm is cut off from the common iliac vessels. , between the distal parts of which form the anastomosis.

Claims (1)

10 Formula of the invention A method for surgical treatment of abdominal aortic aneurysms, including turning off aneurysm from the bloodstream, sequentially applying shunts between both the femoral and right subclavian and femoral arteries, which are cut off in order to reduce the invasiveness of the operation by reducing the operation time. aneurysm from the common iliac vessels, between the distal parts of which form an anastomosis. aneurysms directly under the renal arteries to block blood flow through the aortic iliac segment, a clip is applied. The common iliac arteries down from the aneurysm within the unchanged 5 vessel walls are crossed between the two clamps. The proximal parts of both iliac arteries are ligated twice with stitching. Then, an anastomosis of the end-to-end type is formed between the distal sections of the common iliac arteries. After this, an extraanatomical unilateral linear subclavian-femoral bypass surgery was performed on the right and the pelvic and lower limb organs were included in the main bloodstream. At the end of the operation, a distinct pulsation in the arteries of all segments of both lower extremities was determined. The postoperative period was uneventful, 20 patients were discharged with clinical recovery.