Abstract:

Aim: was to analyze long-term resuts of true lumen reconstruction in complicated aortic dissections type В with help of balloon-expandable stents under intravascular ultrasonic (IVUS) guidance as a preoperative evaluation of anatomy and morphology of lesion.

Materials and methods: 47 patients witn type В aortiс dissections underwent endovascular treatment in our departmert n 20 cases - IVUS was used for irtraoperative anatomy and morphology verification. Complications developed n 16 patients, and true lumen was reconstructed by stent-graft implantation (to cover proximal fenestration) followed by balloon-expandable stents implantation at the level of visceral arteries under IVUS control at every stage. 87,5% of patents were man, mean ago 51 8—16,2 years.

Results: Technical success was 100% True lumen total reconstruction was reached in every case under precise IVUS control. Visceral arteries malperfusion was not observed at hospital period or follow-up. З0-day mortality rate was 6,25% (1 case due to aortic rupture in uncovered part of aorta - 7 days after procedure). All 15 discharged patients survived for 1st year. Mean follow-up period is 3,3±1,6 years. One patient died due to aortobronchial fistula, 1 due to repeated stroke and 1 due to cancer. At CT-scan 2 years after implantation (10 cases) fractures of balloon-expandable stents were observed, without аnу influence on intraluminal size or stenotic lesion. True lumen size stayed stable for 1 year.

Conclusion: true lumen reconstruction under IVUS control seems to be feasible and effective in complicated Type B dissections, even with the use of balloon-expandable stents. The usage of additional intraoperative visualization - intraaortic IVUS is the key point in the development of advanced endovascular methods.

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Abstract:

Authors present their first 3 cases of thoracoabdominal aneurysm hybrid repair. Endovascular procedure and open surgery were used either simultaneously, or as the steps of reconstruction.

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Abstract:

In this study we have analyzed early and long-term results of endovascular abdominal aneurysm repair (EVAR) in the Department of cardio-vascular surgery of «Russian Cardiology Research anc Production Complex».

Material and methods: research includes 164 patients (February 2009-November 2015) with abdominal aortic aneurysm (AAA), who underwent endovascular abdominal aneurysm repair (EVAR), also with difficult anatomy Patients were operated with basic methodics and also hybrid techniques («chimney», «octopus», fenestrated and branched devices).

Results: 30-day mortality rate accounted for 1,2%, all mortality was 3%.

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