Novosti
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This journal is indexed in Scopus |
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Year 2021 Vol. 29 No 2
EXCHANGE OF EXPERIENCE
S.V. MSHAR, V.N. ZASIMOVICH, V.A. ASANOVICH
HYBRID INTERVENTIONS IN EMERGENCY ANGIOSURGERY
Brest Regional Clinical Hospital, Brest, Republic of Belarus
Objective. To improve the results of treatment of patients with multilevel atherosclerotic lesions and aortic dissection.
Methods. In 2019 year 16 hybrid surgical interventions on arteries of lower extremities and 1 hybrid intervention for aortic dissection type B were made in Brest Regional Hospital. Most of the patients were men (15 out of 16), the average age was 60.2±6.4 (M±σ) years. Disease was staged according to the Fontaine–Pokrovsky classification: 4 patients (25%) – IIb, 8 (25%) – III, 4 (25%) – IV. The type of surgery was determined by the level of occlusion / stenosis (according to Doppler ultrasound and angiographic examination) and the state of the outflow tract. According to the TASC II classification, all patients were class C or D. Four groups of hybrid interventions on the arteries of the lower extremities were identified: hybrid on the ilio-femoral segment (n=9), hybrid on the femoral-popliteal segment (n=4), hybrid on the femoral segment (n=1), hybrid on the aorto-iliac segment (n=2).
Results. Technical success was achieved in 100% of cases. In 1 case thrombosis of the superficial femoral artery occurred, which did not require reconstruction due to compensated collateral blood flow, and 1 case of death from acute heart failure. Primary patency was achieved in 93.75% of cases. Duration of hybrid surgery 174.2±67.3 (M±σ) min. Duration of the open stage of the operation – 72.85±30.3 (M±σ) min. The augmentation of the ankle-brachial index (ABI) was 0.26±0.15 (M±σ). Hybrid interventions were performed in the X-ray operating room and always from one vascular access. The amount of iodine-contrasting substance used is 150.8±68 (M±σ) ml.
Conclusion. The use of hybrid interventions provides complete revascularization of lower extremities and minimizes risks of perioperative complications during implantation of aortic stent grafts in type B aortic dissection. Hybrid operations should be considered as the most perspective direction in the development of angiosurgery.
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224027, Republic of Belarus,
Brest, st. Meditsinskaia, 7,
Brest Regional Clinical Hospital,
Angiography Room,
tel .: +375 162 27-22-12,
e-mail: sergei.mshar@gmail.com,
Mshar Sergey V.
Mshar Searhei V. Physician, X-ray Endovascular Surgeon, Angiography Office, Brest Regional Clinical Hospital, Brest, Republic of Belarus.
http://orcid.org/0000-0002-6972-3915
Zasimovich Vladimir N., Head of the Department of Vascular Surgery, Brest Regional Clinical Hospital, Brest, Republic of Belarus.
http://orcid.org/0000-0002-0759-4628
Asanovich Valentin A. Head of the Angiographic Office, Brest Regional Clinical Hospital, Brest,
Republic of Belarus.
http://orcid.org/0000-0002-4124-0655
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