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Hybrid, Quasi and Pseudohybrid Surgical Interventions in the Treatment of Complex Multilevel Multifocal Lesions of the Brachiocephalic Arteriesстатья
- Авторы: Usachev Dmitry, Shulgina Anna, Lukshin Vasily, Yakovlev Sergey
- Сборник: Neurointerventional Surgery: Current Status and Future Prospects
- Глава в коллективной монографии
- Год издания: 2022
- Издательство: Nova Science Publishers, Inc.
- Местоположение издательства: United States
- Первая страница: 161
- Последняя страница: 244
- Номер статьи: Chapter 10
- DOI: 10.52305/wopx9620
- Аннотация: Complex multilevel cerebrovascular pathology – various combinations of arterial aneurysms, arteriovenous malformations, tumors of the neurovascular bundle, pathological deformations, tortuosities, stenoses and thromboses of the main arteries of the head and neck – presents an uncommon and difficult management problem. In such cases, the use of only one surgical method is usually not enough to achieve effective treatment results. There are no approved treatment standards for this category of patients, and their management often requires a special non-trivial approach. Today, such a technology can be a combination of open and endovascular interventions –hybridsurgery. Over a relatively short period, the use of hybrid approach has demonstrated a high technical success of such procedures. The rational use of hybrid technologies can become the key in choosing the tactics of surgical treatment in difficult clinical situations. They provide the possibility of correction of multiple lesions of the brachycephalic arteries on several vascular levels without the use of extensive surgical interventions and subsequently can become a technical alternative to open surgeryand staged reconstructions. The objective of this chapter is to describe the main approaches tothe treatmentof complex combined lesionsof intra-and extracranial parts of the brachiocephalic arteriesand demonstration on clinical examples the possibilities of simultaneous (hybrid),immediate (quasi-hybrid) and delayed (pseudo-hybrid) surgery. The pathologies include combined atherosclerotic lesions of the proximal carotid arteries, brachiocephalic trunk, subclavian and vertebral arteries (various types of staged open and endovascular procedures), giant aneurysms of internal carotid artery(ICA, extra-intracranial bypass + endovascular ICA occlusion), intracranial aneurysms with extracranial tortuosity of carotid arteries (open ICA reconstruction+ endovascular aneurysm occlusion), hypervascular tumors of the neck and head (embolization + tumor removal). The overall goal of combined approach is to optimize treatmenttactics, achieve successful results and reduce the risk of complicationsin the most difficult to treat group of patients with severe combined lesions of the brachiocephalic arteries.
- Добавил в систему: Шульгина Анна Алексеевна