METHOD FOR IMPLANTATION OF BIFURCATED STENT-GRAFT IN INFRARENAL SECTION OF AORTA Russian patent published in 2020 - IPC A61B17/00 A61F2/82 

FIELD: medicine.

SUBSTANCE: invention relates to medicine, specifically to vascular surgery. Arteriotomy of the common femoral artery is performed from both sides. Both femoral arteries are catheterised with an introducer inserted into each femoral artery. Elastic stretch marks are pre-positioned more proximally and distally than the arteriotomy points. Arteriotomy of the common femoral artery is performed from both sides. Both femoral arteries are catheterised and heparinized by intravenous heparin. First femoral artery is catheterised on the side of the main body of the bifurcated stent-graft. Left or right radial artery is punctured and catheterised, and a diagnostic catheter of the Pig Tail type is inserted antegrade into the descending aorta to the level of the renal artery vertebrae. Aortography is performed. Lunderquist Exrta Stiff conductor with an atraumatic end up to the level of the ascending aorta is brought about by using a JR type catheter on the side of the main body of the bifurcation stent-graft installation. Delivery system with a main body and an ipsilateral branch of a bifurcation stent graft is introduced through an arteriotomic approach through the Lunderquist Exrta Stiff guide, in zone proximal to final fixation zone under fluoroscopic control position of bifurcation stent-graft relative to bone reference points on radiogenic contrast markers of undisclosed main body of bifurcation stent-graft. Parallax of the X-ray markers of the undisclosed main body of the bifurcated stent graft is eliminated by varying angiography declination angles. Main body of the bifurcation stent-graft is opened 5 mm above the renal arteries orifices with gradual opening of the links of the main body of the bifurcation stent-graft, bringing the stent-graft down by 1.5 mm below the renal arteries. Further, through the arteriotomic approach from the opposite side of the common femoral artery, the second conductor Lunderquist Exrta Stiff is also introduced by means of the JR catheter, along which the delivering system is carried out from the contralateral branches of the bifurcation stent-graft in the stump of the main body of the bifurcation stent-graft on the background of the bifurcated stent-graft not completely extended and fixed on the stump of the ipsilateral root of the main body. Further, the ipsilateral branch of the main body and the fixing crown are fully opened, the bifurcated stent-graft is released from the delivery system, the arteriotomic approaches are closed, the haemostasis is ensured and a layer-by-layer suture is applied on the wounds.

EFFECT: method enables avoiding developing complications by achieving full sealing of an aneurismal sac and reducing the risk of developing postoperative complications.

1 cl, 1 ex