ABSTRACT
Presented herein is a review of the literature concerning late open conversions after endoprosthetic repair of abdominal aortic aneurysms, followed by analyzing the data on frequency and terms of performing late conversions, indications, options of surgical technique, lethality, and remote results.
Subject(s)
Aortic Aneurysm, Abdominal/surgery , Blood Vessel Prosthesis Implantation/adverse effects , Long Term Adverse Effects , Postoperative Complications , Blood Vessel Prosthesis Implantation/instrumentation , Blood Vessel Prosthesis Implantation/methods , Humans , Long Term Adverse Effects/epidemiology , Long Term Adverse Effects/etiology , Postoperative Complications/epidemiology , Postoperative Complications/etiology , Risk FactorsABSTRACT
Abdominal aortic aneurysms are encountered predominantly in elderly patients suffering from severe concomitant diseases. Therefore, the rate of various complications associated with resection of aortic aneurysm amounts to 30%, with lethality in separate cohorts of patients reaching 43.7%. According the authors' opinion, in the development of intra- and postoperative complications of special importance is the duration of aortic clamping accompanied by severe haemodynamic alterations in coronary, cerebral and renal vessels. These changes are key moments in the development of fatal outcomes. In order to reduce the duration of aortic clamp the authors suggested a non-standard surgical technique of prosthetic repair of the abdominal aorta. Presented herein is a clinical case report illustrating this technique. The patient operated on according to this technique was discharged in a satisfactory condition with no serious postoperative complications. The proposed non-standard surgical technique makes it possible to reduce the duration of aortic cross-clamping in resection of an aneurysm by 10-12 minutes.
Subject(s)
Aorta, Abdominal , Aortic Aneurysm, Abdominal , Postoperative Complications/prevention & control , Vascular Surgical Procedures/methods , Aorta, Abdominal/pathology , Aorta, Abdominal/surgery , Aortic Aneurysm, Abdominal/diagnosis , Aortic Aneurysm, Abdominal/physiopathology , Aortic Aneurysm, Abdominal/surgery , Aortography/methods , Humans , Intraoperative Care/methods , Male , Middle Aged , Monitoring, Intraoperative/methods , Operative Time , Severity of Illness Index , Treatment Outcome , Ultrasonography, Doppler, Duplex/methodsABSTRACT
The authors present immediate and long-term results of treatment of 117 patients with superior thoracic outlet syndrome (STOS). There were different reasons for compression of neu- rovascular fascicle in outlet of the thorax. The costaclavicular syndrome was a reason in 48 patients, additional cervical ribs had 36 patients. Skalenus syndrome was noted in 26 cases, rudimentary cervical ribs or hypertrophy of cervical vertebrae C7 had 7 patients. Raynaud's syndrome took place in 19 cases. The required volume of diagnostic procedures and surgical treatment of STOS were determined according to the cause of the syndrome. Differentiated approach to the different forms of STOS was used in relation to dominant symptoms of the disease and reasons for compression of neurovascular fascicle. This allowed getting positive results in majority of patients (90,4%) in long- term period.
