Репозиторий Университета

© 2018 Russian Electronic Journal of Radiology.All right reserved. Purpose: To assess the role of modern imaging techniques in the planning and implementation of hybrid interventions for an aortic arch aneurysm in an elderly patient with a burdened comorbid background. Materials and methods: Hybrid intervention in patient, 80 years, with acute rupture of the thoracic aorta was performed - aortic arch endografting from the level of the brachiocephalic trunk with endoprosthesis Zenit Alpha endoprosthesis with simultaneous "chimney" stent-graft Advanta V12 implantation in left common carotid artery and left-side carotid-subclavian bypass with Gore-Tex 6 mm prosthesis. Results: A female of 80 years with acute rupture of the thoracic aorta, massive rightside hemothorax has been successfully treated with hybrid intervention - endoprosthetics of the aorta with a subclavian left subclavian shunt. On the second day after procedure the patient underwent puncture of the right pleural cavity with subsequent drainage because of persisting respiratory failure. On the fourth day the patient was transferred from intensive care unit in stable condition, on the twelfth day the patient was discharged on postoperative day 12. Multislice computed tomography (MSCT) is commonly used for diagnosis of acute aortic pathology and planning the optimal method of surgical treatment, as it allows to obtain detailed images of the entire aorta and surrounding anatomical structures, three-dimensional reconstructions of blood vessels, to give an accurate assessment of the morphological characteristics of the aneurysmal sac, proximal and distal neck, degree of calcification and parietal thrombus, localization and extent of aortic wall defect. Conclusion: The use of new methods of endovascular and hybrid surgery in the treatment of aortic rupture of thoracic aortic aneurysms makes it possible to achieve clinical success even in extremely severe patients of elderly and senile age. The leading role in the planning of these operations belongs to actual imaging methods, primarily MSCT.