METHOD FOR FORMING PROXIMAL ANASTOMOSIS IN PROSTHEUSING AORTA IN PATIENTS WITH OCCLUSION OF INFRARENAL DIVISION OF ATHEROSCLEROSITIC GENESIS Russian patent published in 2018 - IPC A61B17/11 

FIELD: medicine.

SUBSTANCE: invention relates to medicine, specifically to vascular surgery. Perform laparatomy. Isolate the abdominal aorta to the level of the renal arteries. Then direct a 4-channel conductor with two swelling cylinders through a jaw inside the bifurcation synthetic prosthesis to its upper edge, where the edge of the prosthesis coincides with the upper edge of the upper balloon. After that, wear the unfolded stent on the upper saggy balloon for half its length – 2 cm. When blowing the upper balloon, the lower half of the stent spreads and it is fixed by hooks to a synthetic vascular prosthesis. After fixing, blow off the upper canister completely. Shift the stent with the prosthesis down the conductor. Perform a puncture of the aorta in the free from calcification and pulsating part of the aorta below the renal arteries. Direct the conductor with blown cylinders upward into the aorta, so that the lower balloon to be located just below the renal arteries, blow the upper balloon until the occlusion of the aorta. Transect the aorta in the transverse direction at the level of the puncture hole. Perform thrombectomy from the proximal aortic stump. Raise the prosthesis of the aorta with the stent to the level of coincidence of the upper edge of the lower balloon with the upper edge of the stent. Blow the bottom balloon, straighten the upper part of the stent at the same time and fix by hooks to the aorta. Through the hole in the conductor between the balloons, aspirate the air from the renal arteries and inject saline to prevent air embolism. Fill the prosthesis through the branch with saline solution with heparin. Blow off the bottom cylinder. Clamp the prosthesis with a soft clamp 3 cm below the stent. Blow off the upper container of the conductor. Remove the conductor from the prosthesis. Apply a clamp to the prosthesis to prevent blood loss.

EFFECT: method makes it possible to form a seamless anastomosis between the calcified aorta and the vascular graft, reduce the traumatism of access, reduce the time of formation of vascular anastomosis, reduce the time of kidney ischemia, exclude radiation exposure to the patient.

1 cl, 6 dwg