title: [Hybrid surgical management of a saccular aneurysm of the aortic arch].
abstract: The present article aims to describe a clinical case of hybrid surgical intervention consisting in complete prosthetic repair of the aortic arch in a high-risk male patient diagnosed with a gigantic saccular aneurysm of the aortic arch. The patient was subjected to a hybrid operation--an operation of endovascular prosthetic repair of the thoracic portion of the aorta with the Gore Tag stent graft in a combination with bypass grafting of the left common carotid and left subclavian arteries with the Gore bifurcated stent graft, autovenous aortocoronary bypass grafting of the CA without artificial circulation. The postoperative period was uneventful with the patient's favourable convalescence and rehabilitation occurring within the shortest terms possible. According to the findings of MSCT-aortography, fulfilment of the arteries of the aortic arch with contrast medium was satisfactory. The residual cavity of the aneurysm was completely isolated from the blood flow, with no endoleak. The arteries of the aortic arch were opacified through the bifurcation prosthesis from the ascending portion of the aorta. Hybrid surgical interventions appear to possess all positive properties of endovascular (according to the findings of the EVAR1 and EVAR2 Trials) and traditional open surgery, thus allowing of both avoiding threatening complications and minimizing the terms of rehabilitation. This technique might thus be considered a useful tool to be included into the basic armamentarium of the vascular surgeon as an option of revascularization.
authors.forename: R S
authors.initials: RS
authors.lastname: Akchurin
authors.forename: T É
authors.initials: TÉ
authors.lastname: Imaev
authors.forename: A E
authors.initials: AE
authors.lastname: Komlev
authors.forename: M R
authors.initials: MR
authors.lastname: Osmanov
authors.forename: M É
authors.initials: MÉ
authors.lastname: Nikonova
authors.forename: I A
authors.initials: IA
authors.lastname: Pokidkin
mesh_terms: D000368:Aged; D001013:Aorta, Thoracic / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery; D017545:Aortic Aneurysm, Thoracic / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery; D001027:Aortography / Q000379:methods; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods / Q000534:rehabilitation; D001026:Coronary Artery Bypass / Q000379:methods / Q000534:rehabilitation; D003331:Coronary Vessels / Q000503:physiopathology / Q000601:surgery; D057867:Endoleak / Q000517:prevention & control; D006801:Humans; D008297:Male; D016343:Monitoring, Intraoperative / Q000379:methods*; D011182:Postoperative Care / Q000379:methods / Q000534:rehabilitation; D020379:Risk Adjustment; D012720:Severity of Illness Index; D013348:Subclavian Artery / Q000503:physiopathology / Q000601:surgery; D013997:Time Factors; D016896:Treatment Outcome