METHOD FOR EXTRACAVITARY BRACHIOCEPHALIC BRANCH SWITCH IN HYBRID TREATMENT OF ANEURISM OF DESCENDING AORTA INVOLVING DISTAL PART OF AORTIC ARCH

摘要

FIELD: medicine.;SUBSTANCE: right common carotid artery is approached first, and then a left common carotid artery and a left subclavian artery are approached second. Having the right common carotid artery clamped between the two clamps, an end-to-side anastomosis of the right common carotid artery is formed using a synthetic prosthesis. A canal is formed under pre-tracheal muscles. The prosthesis is brought along the canal to the left subclavian artery at a minimum distance. The left common carotid artery is transected between the two clamps. An end-to-side anastomosis is formed between a distal portion of the left common carotid artery and the prosthesis. A proximal portion of the common carotid artery is ligated. That is followed by creating an end-to-side anastomosis of the distal end of the prosthesis with the left subclavian artery clamped between the two clamps. The subclavian artery is ligated is a proximal direction from the anastomosis and an origin of the left vertebral artery.;EFFECT: method enables providing higher clinical effectiveness ensured by a lower rate of nearest and remote postoperative neurological disorders associated with left brain hypoperfusion, a synthetic graft thrombosis, and preventing the circulatory decompensation of the left upper limb.;1 ex, 1 dwg