A clinical case of multifocal atherosclerosis 4-step treatment using hybrid technologies

Authors: Marchenko A.V.1, Myalyuk P.A.1, Vronskiy A.S.2

Company: 1 Federal Centre of Cardiovacular Surgery named after S.G. Sukhanov of Ministry of Health of the Russian Federation; ulitsa Marshala Zhukova, 35, Perm', 614000, Russian Federation;
2 Perm State Medical University named after academician E.A. Wagner of Ministry of Health of the Russian Federation; ulitsa Petropavlovskaya, 26, Perm', 614000, Russian Federation

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Type:  Clinical case


DOI: https://doi.org/10.15275/kreatkard.2016.02.08

For citation: Marchenko A.V., Myalyuk P.A., Vronskiy A.S. A clinical case of multifocal atherosclerosis 4-step treatment using hybrid technologies. Kreativnaya Kardiologiya. 2016; 10 (2): 184-190 (in Russian)

Keywords: multifocal atherosclerotic coronary artery bypass grafting carotid endarterectomy vertebral arteries stenting

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Abstract

The article presents a clinical case of the right tactics in patients with multifocal atherosclerotic lesions of the coronary and brachiocephalic arteries and arteries of the lower extremities. After proper preoperative diagnostics of vascular lesions, we decided to perform operations in the following order: the first step was internal carotid artery (ICA) straightening with resection plaque of the left ICA regarding its occlusion and kinking; percutaneous transluminal angioplasty (PTA) and right vertebral artery (VA) stenting were performed a week later. After preventing possible risks of perioperative stroke, the third step was performing coronary artery bypass grafting (CABG) for coronary artery disease (CАD). During the intervention on the brachiocephalic and coronary arteries intraoperative neuromonitoring was performed using cerebral oximetry. The fourth step was carried out by PTA and right common iliac artery (CIA) and external iliac artery (EIA) stenting. By performing surgery in this manner, we avoided perioperative myocardial infarction (MI) and cerebral vascular accident (CVA), as well as complications associated with lower extremities arterial thrombosis.

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About Authors

  • Marchenko Andrey Viktorovich, MD, DM, Cardiovascular Surgeon;
  • Myalyuk Pavel Anatol'evich, Cardiovascular Surgeon;
  • Vronskiy Aleksey Sergeevich, Student.

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery