Endovascular implantation of a stent graft into the aorta in a hybrid operating room using a modern mobile X-ray C-arm: a clinical case

«Radiation and Risk», 2022, vol. 31, No. 2, pp.111-117

DOI: 10.21870/0131-3878-2022-31-2-111-117

Authors

Charchyan E.R. – Head of Dep., MD, Correspondent Member of RAS
Abugov S.A. – Head of Dep., MD, Prof.
Polyakov R.S. – Lead. Researcher, MD, Prof.
Kotenko K.V. – Director, MD, Prof., Correspondent Member of RAS. Petrovsky NRCS.
Sorokin V.G. – Doctor-specialist. Contacts: 1, Ostrovityanov str., Moscow, Russia, 117997. Tel.: +7 (920) 470-09-59; e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it. .
Garbuzov V.V. – Medical Resident. Pirogov RNRMU.
¹ Petrovsky National Research Centre of Surgery, Moscow
² Pirogov Russian National Research Medical University, Moscow

Abstract

Thanks to the development of modern mobile imaging devices, the treatment of such a serious pathology as aortic aneurysm has become more accessible. Thoracic aortic aneurysms are the most common pathology of the thoracic aorta. It occurs with increasing frequency (10 cases per 100,000 people per year). The most common cause of the disease is atherosclerosis. To date, the treatment of this serious pathology has become more accessible due to the development of modern mobile imaging devices. As compared to stationary devices, the portable devices for angiography of the latest generation are movable and can be moved from site to site quickly and easily they produce high quality angiograms, the system can be accessible to any health-care institutions. The paper presents the first in Russia successful case of endoprosthetics of the thoracic aorta using mobile C-arm RFD Ziehm Vision. A 75-year-old man was found to have a symptomatic thoracic aortic aneurysm up to 67 mm in diameter, complicated by intramural (1.2 cm thick) and periaortic hematomas and compression atelectasis of the lower lobe of the left lung. The patient underwent prosthetics of the root, ascending part and arch of the aorta with a 308 (mm) synthetic prosthesis and intraoperative stenting of the descending thoracic aorta on a mobile C-arm. Our clinical experience shows that difficult hybrid interventions can be successful if they are carried out in a surgical operating room with the use of a high-power C-arm with angiography function. This approach allows specialists to obtain image of required quality, with low exposure of a patient to ionizing radiation. The method can be used in the absence of stationary angiographs.

Key words
thoracic aortic aneurysm, stent graft, endograft, mobile C-arm, hybrid interventions, CT angiography of aortic aneurysm, thoracic aortic prosthetics, thoracic aortic stenting, cath labs.

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