METHOD FOR TREATMENT OF SUBCLAVIAN ARTERIES DEFECTS WITH VERTEBRAL-SUBCLAVIAN STEAL SYNDROME Russian patent published in 2017 - IPC A61B17/00 A61B8/00 A61F2/01 

FIELD: medicine.

SUBSTANCE: presence of hemodynamically significant U3-signs of affection of SA and VSSS is determined against a background of combined stenosis of CA or isolated lesion of SA. With isolated lesion of SA, stenting is performed through the brachial approach. If the operation fails, this access is performed through the thigh. If the operation fails with this access too, preconditioning procedure is performed followed by a procedure of carotic subclavian shunting using the external jugular vein as an auto-shunt with mandatory compression of the vertebral artery at the time of anastomosis with the CA. In case of combined CA stenosis through the femoral approach, digital subtraction angiography of brachiocephalic arteries is performed and the side of CA lesion is determined with respect to the affected SA. In case of bilateral or contralateral combined CA stenosis, brain perfusion studies are performed and the side with less perfusion characteristics is revascularized. In case of ipsilateral combined CA stenosis, SA stenting from the femoral approach is performed. If the operation fails, brachial access is performed. If the operation fails with this access too, preconditioning procedure is performed followed by carotid endarterectomy (CEAE) and simultaneous carotic subclavian shunting using the external jugular vein as an auto-shunt with mandatory compression of the vertebral artery at the time of anastomosis with the CA. In case of ipsilateral combined CA stenosis, if SA stenting is successful, CA revascularization is performed. In case of contralateral combined CA stenosis, if the smaller perfusion characteristics refer to the side without SA lesion, the CA is revascularized first, and then the patient is treated in the same way as with an isolated SA lesion. In case of contralateral combined CA stenosis, if the smaller perfusion characteristics refer to the side with SA lesion, then the patient is treated in the same way as with an isolated SA lesion, and then the CA is revascularized. In case of bilateral combined CA stenosis, if the smaller perfusion characteristics refer to the side with SA lesion, then the patient is treated in the same way as with an ipsilateral combined CA stenosis. If the perfusion characteristics refer to the side without SA lesion, then the patient is treated in the same way as with a contralateral combined CA stenosis.

EFFECT: intra- and postoperative complications associated with revascularization of subclavian and carotid arteries are avoided.

1 dwg