Journal «Angiology and Vascular Surgery» • 

2019 • VOLUME 25 • №1

Hibrid surgical treatment of an aortic arch aneurysm

Chernyavsky M.A., Zherdev N.N., Chernov A.V., Gusev A.A., Chernova D.V., Kudaev Yu.A.

Research Department of Vascular and Interventional Surgery, Research Laboratory of Vascular and Hybrid Surgery, National Medical Research Centre named after V.A. Almazov under the RF Ministry of Public Health, Saint Petersburg, Russia

Presented in the article is a clinical case report regarding hybrid surgical management of a saccular aneurysm of the aortic arch: simultaneous right-left-carotid-left-subclavian bypass grafting and endovascular isolation of the aneurysm. Taking into consideration the findings of multislice computed tomography-aortography (MSCT aortography) prior to surgery, the anatomical location of the aneurysm with the involvement of the ostium of the left subclavian artery, close location of the proximal branches of the aortic arch at an acute angle relative to each other required performing simultaneous debranching in order to enlarge the proximal zone of fixation of a stent graft at the level of the brachiocephalic trunk (BCT). The postoperative period proved uneventful, with as rapid rehabilitation as possible.

From our own experience, with this one being not the first similar operation performed in the Centre, it may be supposed that carrying out simultaneous hybrid interventions in treatment of aneurysms of the aortic arch with the use of different variants of switching its branches may decrease the frequency of postoperative complications for patients of high surgical risk, reduce the length of hospital stay and, consequently, economic expenditures for treatment.

KEY WORDS: aortic arch aneurysm, left-carotid-left-subclavian bypass grafting, right-left-carotid-left-subclavian bypass grafting, endovascular isolation of thoracic aortic aneurysm.

P. 168

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