Научно-практический журнал
«Клиническая физиология кровообращения»

ISSN 1814-6910 (Print)
ISSN 2410-9134 (Online)

 

Главный редактор

Лео Антонович Бокерия, доктор медицинских наук, профессор, академик РАН и РАМН, президент ФГБУ «НМИЦ ССХ им. А.Н. Бакулева» МЗ РФ


Каталог статей ➤ КФК. 2023; 20 (2): 89-202 ➤ Успешное хирургическое лечение аневризмы верхней брыжеечной артерии в сочетании с экстравазальной компрессией чревного ствола у пациентки с гематурией

Успешное хирургическое лечение аневризмы верхней брыжеечной артерии в сочетании с экстравазальной компрессией чревного ствола у пациентки с гематурией

Авторы: Аракелян В.С.1, Букацелло Р.Г.1,2, 2, Гамзаев Н.Р.1, Черных Н.А.1, Кидакоев Р.З-Г. 1

Организация:
1 ФГБУ «Национальный медицинский исследовательский центр сердечно-сосудистой хирургии им. А.Н. Бакулева» Минздрава России, Москва, Российская Федерация
2 ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздрава России, Москва, Российская Федерация

Для корреспонденции: Сведения доступны для зарегистрированных пользователей.

Раздел: Клинические случаи

DOI: https://doi.org/10.24022/1814-6910-2023-20-2-193-202

УДК: 616.136.46-007.64-089

Библиографическая ссылка: Клиническая физиология кровообращения. 2023; 2 (20): 193-202

Цитировать как: Аракелян В.С., Букацелло Р.Г., Гамзаев Н.Р., Черных Н.А., Кидакоев Р.З-Г. . Успешное хирургическое лечение аневризмы верхней брыжеечной артерии в сочетании с экстравазальной компрессией чревного ствола у пациентки с гематурией. Клиническая физиология кровообращения. 2023; 2 (20): 193-202. DOI: 10.24022/1814-6910-2023-20-2-193-202

Поступила / Принята к печати:  23.05.2023 / 15.06.2023

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Аннотация

Лечение аневризм верхней брыжеечной артерии и ее ветвей остается серьезным вызовом для хирургического сообщества. В обзоре представлены тактические особенности двух основных направлений при лечении патологии артерий висцерального бассейна: классическое – хирургическое и рентгенэндоваскулярное с использованием как окклюзионных методов, так и различных видов стентов. Критериями, усложняющими выбор предпочтительного варианта лечения, являются размеры, тип и локализация аневризмы, анатомия спланхнического артериального бассейна, особенности висцеральной гемодинамики и выраженность коллатерализации, анатомическое соседство с органами брюшной полости и ряд других. Несмотря на постоянное совершенствование эндоваскулярной техники вмешательств и позитивные результаты этого малоинвазивного альтернативного варианта лечения висцеральных аневризм, в клинический практике встречаются случаи, при которых внутрисосудистый способ «выключения» аневризмы оказывается технически сложным или невыполнимым и несет риски мезентериальной ишемии.

При выборе варианта коррекции комплексная оценка состояния всех висцеральных артерий и анатомии спланхнического бассейна в ряде случаев является определяющей. В представленном клиническом случае описан опыт лечения комбинированного поражения мезентериальных артерий, потребовавшего разработки детальных этапности и техники операции одновременно в двух бассейнах висцерального артериального русла для профилактики возможных ишемических и геморрагических осложнений.

Литература

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  1. Wang L., Shu C., Li Q., Jiang X., Li X., He H. et al. Experience of managing superior mesenteric artery aneurysm and its midterm follow-up results with 18 cases. Vascular. 2021; 29 (4): 516–26. DOI: 10.1177/1708538120962884
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  10. Khairallah M.K., Morgan R.A., Das R. Technical considerations of endovascular management of true visceral artery aneurysms. CVIR Endovasc. 2023; 6: 31. DOI: 10.1186/s42155-023-00368-9
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Об авторах

  • Аракелян Валерий Сергеевич, д-р мед. наук, профессор, руководитель отделения хирургии артериальной патологии; ORCID
  • Букацелло Роман Геннадьевич, канд. мед. наук, ст. науч. сотр. отделения хирургии артериальной патологии, сердечно-сосудистый хирург; ORCID
  • Гамзаев Назим Рагимович, канд. мед. наук, ст. науч. сотр. отделения хирургии артериальной патологии, сердечно-сосудистый хирург; ORCID
  • Черных Николай Александрович, аспирант отделения хирургии артериальной патологии, сердечно-сосудистый хирург; ORCID
  • Кидакоев Рустам Забыт-Гериевич, аспирант отделения хирургии артериальной патологии, сердечно-сосудистый хирург; ORCID

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