Improved Crowford treatment of type III thoracoabdominal aortic aneurysm one cases.docVIP

 PAGE \* MERGEFORMAT 13 Improved Crowford treatment of type III thoracoabdominal aortic aneurysm one cases [Keywords:] aortic aneurysm, thoracic aorta, abdominal surgery Large range of abdominal aortic aneurysm, thoracic and abdominal cavities, often involving the important visceral branch arteries, difficult surgery, visceral ischemia caused by arterial clamp block due to the branch of the aorta and other vital organs and the failure rate, especially kidney dysfunction is one of the postoperative death [1,2], I use additional renal artery bypass improved Crowford method Ⅲ in abdominal aortic aneurysm artificial blood vessel replacement surgery effect, described below. 1 Materials and Methods 1.1 The clinical data of male, 63 years old, low back pain 1d admission, physical examination found abdominal pulsatile mass. Enhanced spiral CT shows: Crowford III thoracoabdominal aortic aneurysm, tumor edge up to the T10 level, the lower edge of dual internal and external iliac bifurcation level, the total length of about 32cm.T10 to the level of renal vein tumor outside diameter 5.5cm, kidney tumor maximum outside diameter of 13cm, the maximum outer diameter of the left common iliac artery tumor 6cm, the right common iliac artery tumor maximum external diameter of 7cm the right iliac aneurysmal change, the outside diameter of 3cm. pairs of common iliac artery around the tumor is visible ring enhanced right retroperitoneal since the right iliac fossa to the level of the right renal vein can be seen wrapped images of large areas of soft tissue, considering the aneurysm rupture in the peritoneal package. check heart, lungs, liver, kidney, blood, metabolism and other important systems and organs function index is normal at 3 days after admission surgery. 1.2 Procedures double-lumen endotracheal intubation, the position of “twist” and the first half of the body right hand 75 held fixed on the left upper extremity, slightly elevate the left hip, lower limb horizo