Doklad 2 presentation

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Doklad 2 presentation

  1. 1. The first hybrid stent-grafting procedure of thoracic aorta (1991) - successful follow-up for 23 years Professor Nikolay VOLODOS, Kalashnykova Yuliia Kharkov, UKRAINE
  2. 2. HYBRID PROCEDURES List of publications 2013-2014 • De Rango P., Cao P. et al. Aortic debranching and thoracic endovascular repair // J. Vasc. Surg. – 2014. – Vol. 59, N 1. – P.107 - 114. • Bavaria J., Vallabhajosyula P. et al. Hybrid approach in the treatment of aortic arch aneurysms: postoperative and midterm outcomes // J. Thorac. Cardiovasc. Surg. – 2013. – Vol. 145 (3 Suppl). – P. S85 - 90. • Benedetto U., Melina G. et al. Current results of open total arch replacement versus hybrid thoracic endovascular aortic repair for aortic arch aneurysm: a meta-analysis of comparative studies // J. Thorac. Cardiovasc. Surg. – 2013. – Vol. 145. – P. 305 - 306. • Lorii S., Clough R.E. et al. Hybrid repair of complex thoracic aortic arch aneurysm pathology: long-term outcomes of extra-anatomic bypass grafting of the supra-aortic trunk // Cardiovasc. Intervent. Radiol. 2013. – Vol.36. – P. 46 – 55. • Preventza O., Aftab M., Coselli J.S. Hybrid techniques for complex aortic arch surgery // Texas Heart Institute Journal. – 2013. – Vol.40, N 5. – P.568 – 571. • Preventza O. et al. Deployment of proximal thoracic endograft in xone 0 of the ascending aorta: treatment options and early outcomes for aortic arch aneurysms in high-risk population // Eur. J. Cardiothorac. Surg. – 2013. – Vol.44, N3. – P.446 – 453. • Cherny M. et al. Hybrid aortic arch repair // Ann. Cardiothorac. Surg. – 2013. – Vol.2, N3. – P.372 – 377. • Cherny M. et al. Transposition of the supra-aortic vessels before stent-grafting the aortic arch and descending aorta // J. Thorac. Cardiovasc. Surg. – 2013. – Vol. 145. – P. S91 – 97. • Vallabhajosyula P. et al. Type II arch hybrid debranching procedure // Ann. Cardiothorac. Surg. – 2013. – Vol.2, N3. – P.378 – 386. • Andersen N.D. et al. Results with an algorythmic approach to hybrid repair of the aortic arch // J. Vasc. Surg. – 2013. – Vol. 57, N 3. – P.655 - 667. • Etc.
  3. 3. The date of procedure THE FIRST HYBRID PROCEDURE FOR AORTIC ARCH ANEURYSM: 14 JUNE, 1991
  4. 4. THE FIRST HYBRID PROCEDURE FOR AORTIC ARCH ANEURYSM: JUNE, 1991 Volodos N.L., Karpovich I.P., Troian V.I., et al. Clinical experience of the use of self-fixing synthetic prostheses // Angiologie. - VASA. - 1991. Suppl.33. - P.93-95.
  5. 5. SCHEMATIC DRAWING OF THE FIRST HYBRID PROCEDURE WITH DEBRANCHING FOR AORTIC ARCH ANEURYSM: JUNE, 1991
  6. 6. Delivery system for endovascular part of hybrid procedure
  7. 7. SCHEMATIC DRAWING OF THE FIRST HYBRID PROCEDURE WITH DEBRANCHING FOR AORTIC ARCH ANEURYSM: JUNE, 1991
  8. 8. СT scan 10 years after the hybrid procedure • The position of the endoprosthesis is unchanged/stable
  9. 9. СT scan 23 years after the hybrid procedure
  10. 10. Lower endUpper end СT scan 23 years after the hybrid procedure
  11. 11. Internal carotid arteries and subclavian arteries left right Considerable asymmetry of linear flow velocity is not observed in both internal carotid arteries and in both subclavian arteries
  12. 12. Vertebral arteries and basilar artery left right basilar Significant asymmetry in the linear velocity of anterior cerebral arteries is not observed In both vertebral arteries and in basilar artery blood flow velocity has a value within the age norm
  13. 13. Autovenous shunt anastomosis with LCCA with LSubA Abdominal aorta
  14. 14. Conclusions: • The endoprosthesis has been functioning well for the duration of the whole time of follow-up – 23 years after hybrid operation. • The system of blood flow created in the result of debranching provides normal blood flow of the brain and the upper body for the duration of the long time. • The combined (hybrid) method of endovascular-surgical prosthetic repair of the aorta arch aneurysm in combination with strengthening of the load zone is effective in terms of long-term results. • The method of a hybrid prosthetic repair of the aorta arch aneurysm, being the most universal one from the point of view of the most complicated anatomical variants of the aorta arch aneurysm, should be perfected with taking into account the newest achievements of endovascular technology, new endoprostheses, new delivery systems for prevention such complications as proximal dissection, stroke etc. • Taking into account the fact that there are so many anatomical variants of the aorta arch aneurysms, especially in cases with multisegmental thoracic aortic pathologies one can be sure that this method will be in demand as a real clinical practice.

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