在混合手术室使用现代移动x线c臂血管内支架植入主动脉:一例临床病例

E. Charchyan, S. Abugov, R. S. Polyakov, V. G. Sorokin, V. Garbuzov, K. Kotenko
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摘要

由于现代移动成像设备的发展,治疗像主动脉瘤这样严重的病理变得更加容易。胸主动脉瘤是最常见的胸主动脉病变。它的发生频率越来越高(每年每10万人中有10例)。最常见的病因是动脉粥样硬化。迄今为止,由于现代移动成像设备的发展,这种严重病理的治疗变得更容易获得。与固定设备相比,最新一代的便携式血管造影设备是可移动的,可以快速轻松地从一个站点移动到另一个站点,它们可以产生高质量的血管造影,任何医疗机构都可以使用该系统。本文介绍了俄罗斯第一个使用移动c臂RFD Ziehm Vision的胸主动脉内假体的成功案例。一位75岁男性被发现有症状性胸主动脉瘤,直径达67毫米,并发左肺下叶壁内(1.2厘米厚)和主动脉周围血肿和压迫性肺不张。患者采用30x8 (mm)人工假体对主动脉根、升段和弓进行假体修复,术中在移动c型臂上置入胸降主动脉支架。我们的临床经验表明,如果在外科手术室使用具有血管造影功能的高倍率c型臂进行困难的混合干预,可以取得成功。这种方法使专家能够获得所需质量的图像,患者暴露于电离辐射的程度很低。该方法可以在没有固定血管造影的情况下使用。
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Endovascular implantation of a stent graft into the aorta in a hybrid operating room using a modern mobile X-ray C-arm: a clinical case
Thanks to the development of modern mobile imaging devices, the treatment of such a serious pa-thology as aortic aneurysm has become more accessible. Thoracic aortic aneurysms are the most common pathology of the thoracic aorta. It occurs with increasing frequency (10 cases per 100,000 people per year). The most common cause of the disease is atherosclerosis. To date, the treat-ment of this serious pathology has become more accessible due to the development of modern mobile imaging devices. As compared to stationary devices, the portable devices for angiography of the latest generation are movable and can be moved from site to site quickly and easily they produce high quality angiograms, the system can be accessible to any health-care institutions. The paper presents the first in Russia successful case of endoprosthetics of the thoracic aorta using mobile C-arm RFD Ziehm Vision. A 75-year-old man was found to have a symptomatic thoracic aortic aneurysm up to 67 mm in diameter, complicated by intramural (1.2 cm thick) and periaortic hematomas and compression atelectasis of the lower lobe of the left lung. The patient underwent prosthetics of the root, ascending part and arch of the aorta with a 30x8 (mm) synthetic prosthesis and intraoperative stenting of the descending thoracic aorta on a mobile C-arm. Our clinical expe-rience shows that difficult hybrid interventions can be successful if they are carried out in a surgical operating room with the use of a high-power C-arm with angiography function. This approach al-lows specialists to obtain image of required quality, with low exposure of a patient to ionizing radia-tion. The method can be used in the absence of stationary angiographs.
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