Cíl: Zhodnotit průchodnost fenestrací pro renální tepny, horní mezenterickou tepnu a truncus coeliacus u pacientů po implantaci fenestrovaných a větvených stentgraftů pro pararenální aneurysma břišní aorty. Dalším cílem bylo zhodnotit výskyt pozdního endoleaku typu Ia. Metodika: V období od roku 2002 do roku 2023 bylo na našem pracovišti léčeno 87 pacientů s pararenálním aneurysmatem břišní aorty implantací fenestrovaného nebo větveného stentgraftu. Z toho bylo 14 žen a 73 mužů ve věku od 51 do 86 let, věkový průměr byl 72 let. Rok a déle (1–13 let) bylo sledováno 69 pacientů, a to CT angiografií jednou ročně. Průměrná doba sledování byla 4,7 let, medián 4 roky. Celkový počet fenestrací a větví u 87 nemocných byl 266. Déle než rok bylo sledovaných 209 fenestrací a větví. Výsledky: Celkově došlo k uzávěru jedenácti fenestrací a větví, dvě se uzavřely během prvního roku, šest za rok po výkonu, dvě 2 roky po výkonu a jedna se uzavřela 6 let po výkonu. Jednoroční průchodnost byla v celém souboru 96,2 %, tříletá průchodnost byla 95,1 % a pětiletá průchodnost pak 95,1 %. Během sledování jsme u žádného pacienta nezaznamenali endoleak typu Ia. Závěr: Průchodnost fenestrací a větví u pacientů po implantaci fenestrovaných a větve- ných stentgraftů pro pararenální aneurysma břišní aorty je dobrá. Zlepšení proximální fixace pak vede ke snížení rizika migrace a výskytu endoleaku typu Ia.
Aim: To evaluate the patency of fenestrations for the renal arteries, superior mesenteric artery, and truncus coeliacus in patients after implantation of fenestrated and branched stent-grafts for pararenal abdominal aortic aneurysm. Another objective was to evaluate the incidence of late type Ia endoleak. Methodology: In the period from 2002 to 2023, 87 patients with pararenal aneurysm of the abdominal aorta were treated at our institution with the implantation of a fenestrated or branched stent-graft. There were 14 women and 73 men aged from 51 to 86 years, the average age was 72 years. Sixty-nine patients were followed-up a year or longer (1–13 years), with CT angiography once a year. Mean follow-up was 4.7 years, median 4 years. The total number of fenestrations and branches in 87 patients was 266. Two hundred and nine fenestrations were followed for longer than a year. Results: A total of 11 fenestrations and branches were occluded, 2 within the first year, 6 one year postoperatively, two fenestrations 2 years postoperatively, and one fenestration was occluded 6 years after procedure. One-year primary patency of fenestrations was 96.2%, three-year patency was 95.1%, and five-year patency was 95.1%. During follow-up, we did not observe a type Ia endoleak in any patient. Conclusion: Patency of fenestrations and branches in patients after implantation of fenestrated and branched stent-grafts for pararenal abdominal aortic aneurysm is good. The improvement of proximal fixation then leads to a reduction in the risk of migration and the occurrence of a type Ia endoleak.
AIMS: To evaluate the estimated fetal radiation dose during prophylactic internal iliac arterial occlusion in patients with abnormal placenta and to estimate the risk of radiation induced cancer in child age. METHODS: Prophylactic occlusion of the internal iliac arteries during Caesarean section was performed in 42 patients with placenta praevia and/or placenta accreta spectrum. Fogarty embolectomy catheters were used for prophylactic occlusion of the internal iliac arteries. All procedures were performed in the hybrid operating room using Philips Allura Xper FD 20 X-ray system. Low dose X-ray fluoroscopy (7.5 frames per second) was used. The CODE (Conceptus dose estimation) Software was used to estimate the fetal dose and the risk of radiation induced carcinoma. RESULTS: Fluoroscopy times required for insertion of Fogarty catheters were 0.5-4.2 min (mean: 1.7 min, median: 1.5 min). The estimated radiation dose to the fetus was 0.26-3.36 mGy (mean: 1.49 mGy, median: 1.25 mGy). The risk of radiation induced cancer in child age was 0.01-0.04% (mean 0.02%, median 0.01%). One patient developed thrombosis of a common femoral artery. CONCLUSION: Prophylactic occlusion of the internal iliac arteries is a simple and safe procedure with minimal risk of complications and with a very low estimated radiation dose to the fetus.
- MeSH
- Balloon Occlusion * MeSH
- Cesarean Section MeSH
- Radiation Dosage MeSH
- Child MeSH
- Blood Loss, Surgical MeSH
- Humans MeSH
- Neoplasms, Radiation-Induced * MeSH
- Placentation MeSH
- Fetus MeSH
- Retrospective Studies MeSH
- Pregnancy MeSH
- Check Tag
- Child MeSH
- Humans MeSH
- Pregnancy MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Keywords
- kvalita obrazu, dynamický fantom,
- MeSH
- Obesity, Abdominal * diagnostic imaging MeSH
- Angiography * classification methods instrumentation MeSH
- Radiation Dosage MeSH
- Humans MeSH
- Obesity, Morbid diagnostic imaging MeSH
- Check Tag
- Humans MeSH
- Publication type
- Comparative Study MeSH
