[The surgery and endovascular surgery of thoracoabdominal aortic aneurysms with the use of vascular prostheses].
The authors present etiology, diagnosis and operative treatment of thoracoabdominal aneurysms based on their own experiences, especially in performing proximal anastomosis between vascular graft and aorta. The protheses are made of polytertafluoroethylene or dacron. They are impregnated with colagen or soaked with argentum or antibiotics. Spinal cord and visceral organ protection is described. The authors present also endovascular treatment of aorta. Internal chasis of vascular protheses (stentgrafts) is made of biologically neutral metal (like stainless stell, nitinol, other alloys). Its diameter is simmilar to abdominal or thoracic aorta dimension. The chasis is covered by material used also to produce classic vascular protheses (polytetrafluoroethylene, dacron). Thoracoabdominal aneurysms occur rarely, but they are the most difficult problem in vascular surgery. According to literature occurrence of aneurysms in this section value from 4% to 10%. Atherosclerotic process is a exciting cause of this type of aneurysms. According to modified Crawfords classification there are five basic types of thoracoabdominal aneurysms. For pioneer of thoracoabdominal aneurysms surgical treatment one should to recognize S. Etheredge, who in 1954 as a first performed human, aortal homograft implantation with using temporary by-pass. In 1973 E. S. Crawford proposed a new way of management depended on in situ anastomosis between arterial trunks with prosthesis, without use of temporary bypass. In Anglo-Saxon literature this technique gained descriptive qualification "clamp and sew". Using this method, thoracoabdominal aneurysms surgery stood himself decidedly shorter and safer for patients.
Pupka
Artur
A
Katedra i Klinika Chirurgii Naczyniowej, Ogólnej i Transplantacyjnej AM we Wrocławiu. apupka@chirn.am.wroc.pl
Pawłowski
Stanisław
S
Szyber
Przemysław
P
Janczak
Dariusz
D
Szyber
Piotr
P
D000497:Alloys; D017544:Aortic Aneurysm, Abdominal / Q000628:therapy*; D017545:Aortic Aneurysm, Thoracic / Q000601:surgery*; D001166:Arteriovenous Shunt, Surgical / Q000379:methods; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation; D006801:Humans; D007431:Intraoperative Complications / Q000517:prevention & control; D011138:Polytetrafluoroethylene; D011183:Postoperative Complications / Q000517:prevention & control; D012307:Risk Factors; D015607:Stents; D015996:Survival Rate; D014656:Vascular Surgical Procedures / Q000379:methods
D000497:Alloys; C013616:nitinol; D011138:Polytetrafluoroethylene