The main causes are organic diseases or injury of the vessel walls due to heredity or acquired disease. Aneurysms occur in any blood vessel, most often in the brain, thoracic and abdominal aorta and in the heart.
As the aneurysm grows in size, so does the risk of rupture, which can lead to bleeding episodes, blood clots, embolism and even death.
How is it treated?
There are two methods of treating thoracic and abdominal aortic aneurysms, minimally invasive intravascular, transcatheter and open surgery.
The advantages of the intravascular method are obvious: absence of incision, reduced complications, reduced mortality, faster discharge from the hospital, faster recovery and absence of significant postoperative pain.
The most common aneurysms treated intravascularly are in the descending thoracic aorta. The transcatheter method using the latest generation of endometrial implants (aortic stents) has almost completely replaced open surgery with excellent results.
“In recent years, advances in technology have allowed us to extend the use of the transcatheter method to both complex aortic and thoracic aneurysms. The treatment in these places is achieved with the use of specialized Fenestrated or Branched grafts. In these specific aneurysms there are clear indications and contraindications for the application of intercostal surgery. Today, intercostal surgeries are performed on patients whose open surgery is a contraindication due to other problems “, explains Mr. Christoforos S. Kotoulas, Cardiac Surgeon, Director of the Minimally Invasive Heart-Thoracic Surgery Clinic of the Metropolitan General.
How are intercostal surgeries performed?
Transplantation surgeries are performed by surgeons with experience in both methods, in state-of-the-art surgeries called hybrids, performed with state-of-the-art materials.
The patient has undergone a preoperative axial orthography to calculate exactly the size of the implant in diameter and length. The minimally invasive intravascular method usually prepares a femoral artery in the groin. This is followed by a needle puncture and with the help of guide wires and catheters the implant is placed inside the aneurysm lumen, always under the guidance of the X-ray machine. A final angiography is performed to confirm the results.
Hemodynamic pressures in the thoracic aorta are significantly greater than those in the abdominal aorta. This results in the need for more durable endothelium grafts capable of withstanding these adverse conditions.
Complications
“Problems that can occur are spinal cord ischemia with the possible consequence of the appearance of paraplegia due to the Adamkiewicz artery, which can be covered by the implant and whose position is not stable. This possibility is reduced when the length of the implant is less than 20 cm, when there is no drop in blood pressure intraoperatively. 10mmHg. However, it is observed less frequently when the patient is treated intravascularly than with the classical method.
Another problem with the method is the intrusions between the implant and the aortic wall, which may need further treatment.
The average length of hospital stay is 3-4 days. “The postoperative follow-up of patients after intravascular rehabilitation receives greater value compared to open surgical rehabilitation and is done with axial orthography”, points out Mr. Kotoulas.
Writes:
Mr. Christoforos S. Kotoulas, Cardiac Surgeon,
Director of the Minimally Invasive Cardiac-Thoracic Surgery Clinic of the Metropolitan General
Follow Skai.gr on Google News
and be the first to know all the news
