"Akutn\u00ED endovaskul\u00E1rn\u00ED \u0159e\u0161en\u00ED disekce hrudn\u00ED aorty a n\u00E1sledn\u00E9 isch\u00E9mie doln\u00EDch kon\u010Detin" . "\u0160ediv\u00FD, Petr" . "Akutn\u00ED endovaskul\u00E1rn\u00ED \u0159e\u0161en\u00ED disekce hrudn\u00ED aorty a n\u00E1sledn\u00E9 isch\u00E9mie doln\u00EDch kon\u010Detin"@cs . . . "0035-9351" . "4" . "CZ - \u010Cesk\u00E1 republika" . "Endovascular treatment of acute thoracic aorta dissection and subsequent lower extremities ischemia"@en . . "Rozhledy v chirurgii" . "RIV/00023884:_____/08:#0002711" . "B dissection, endovascular, hybrid procedure"@en . "Situace: \u0158e\u0161en\u00ED akutn\u00ED disekce typu B hrudn\u00ED aorty implantac\u00ED tubul\u00E1rn\u00EDho stentgraftu se v posledn\u00EDch letech stalo atraktivn\u00ED alternativou p\u0159\u00EDpadn\u00E9 otev\u0159en\u00E9 operace. Klasick\u00FD opera\u010Dn\u00ED v\u00FDkon je u komplikovan\u00FDch disekc\u00ED prov\u00E1zen a\u017E 50% mortalitou a protrahovan\u00FDm pobytem pacienta na JIP. P\u0159i endovakul\u00E1rn\u00EDm v\u00FDkonu je morbidita i mortalita v\u00FDrazn\u011B ni\u017E\u0161\u00ED. Zat\u00EDm nen\u00ED dostatek zku\u0161enost\u00ED, jak se septum disekce a ob\u011B lumina budou po zaveden\u00ED stentgraftu chovat. Popis p\u0159\u00EDpadu: Implantovali jsme tubul\u00E1rn\u00ED stentgaft \u010Dty\u0159icetidev\u00EDtilet\u00E9mu pacientovi s akutn\u00ED disekc\u00ED B. Po operaci do\u0161lo k bezprost\u0159edn\u00EDm ischemick\u00FDm a neurologick\u00FDm komplikac\u00EDm, kter\u00E9 si vy\u017E\u00E1daly reoperaci a prodlou\u017Een\u00FD pobyt na JIP. Jsou rozebr\u00E1ny p\u0159\u00ED\u010Diny a pops\u00E1n zp\u016Fsob \u0159e\u0161en\u00ED. Z\u00E1v\u011Br: Endovaskul\u00E1rn\u00ED \u0159e\u0161en\u00ED disekce B je atraktivn\u00ED a pro pacienta i person\u00E1l m\u00E9n\u011B n\u00E1ro\u010Dn\u00FD opera\u010Dn\u00ED v\u00FDkon ve srovn\u00E1n\u00ED s klasickou otev\u0159enou operac\u00ED. P\u0159i zm\u011Bn\u00E1ch tlak\u016F v prav\u00E9m a neprav\u00E9m luminu aorty m\u016F\u017Ee doj\u00EDt k n\u00E1hl\u00FDm zm\u011Bn\u00E1m perf\u00FAze org\u00E1n\u016F nebo kon\u010Detin. Tyto komplikace je nutno o\u010Dek\u00E1vat a neodkladn\u011B \u0159e\u0161it. Operace tohoto typu je vhodn\u00E9 prov\u00E1d\u011Bt v klinick\u00FDch centrech s pat\u0159i\u010Dn\u00FDm z\u00E1zem\u00EDm."@cs . "Situace: \u0158e\u0161en\u00ED akutn\u00ED disekce typu B hrudn\u00ED aorty implantac\u00ED tubul\u00E1rn\u00EDho stentgraftu se v posledn\u00EDch letech stalo atraktivn\u00ED alternativou p\u0159\u00EDpadn\u00E9 otev\u0159en\u00E9 operace. Klasick\u00FD opera\u010Dn\u00ED v\u00FDkon je u komplikovan\u00FDch disekc\u00ED prov\u00E1zen a\u017E 50% mortalitou a protrahovan\u00FDm pobytem pacienta na JIP. P\u0159i endovakul\u00E1rn\u00EDm v\u00FDkonu je morbidita i mortalita v\u00FDrazn\u011B ni\u017E\u0161\u00ED. Zat\u00EDm nen\u00ED dostatek zku\u0161enost\u00ED, jak se septum disekce a ob\u011B lumina budou po zaveden\u00ED stentgraftu chovat. Popis p\u0159\u00EDpadu: Implantovali jsme tubul\u00E1rn\u00ED stentgaft \u010Dty\u0159icetidev\u00EDtilet\u00E9mu pacientovi s akutn\u00ED disekc\u00ED B. Po operaci do\u0161lo k bezprost\u0159edn\u00EDm ischemick\u00FDm a neurologick\u00FDm komplikac\u00EDm, kter\u00E9 si vy\u017E\u00E1daly reoperaci a prodlou\u017Een\u00FD pobyt na JIP. Jsou rozebr\u00E1ny p\u0159\u00ED\u010Diny a pops\u00E1n zp\u016Fsob \u0159e\u0161en\u00ED. Z\u00E1v\u011Br: Endovaskul\u00E1rn\u00ED \u0159e\u0161en\u00ED disekce B je atraktivn\u00ED a pro pacienta i person\u00E1l m\u00E9n\u011B n\u00E1ro\u010Dn\u00FD opera\u010Dn\u00ED v\u00FDkon ve srovn\u00E1n\u00ED s klasickou otev\u0159enou operac\u00ED. P\u0159i zm\u011Bn\u00E1ch tlak\u016F v prav\u00E9m a neprav\u00E9m luminu aorty m\u016F\u017Ee doj\u00EDt k n\u00E1hl\u00FDm zm\u011Bn\u00E1m perf\u00FAze org\u00E1n\u016F nebo kon\u010Detin. Tyto komplikace je nutno o\u010Dek\u00E1vat a neodkladn\u011B \u0159e\u0161it. Operace tohoto typu je vhodn\u00E9 prov\u00E1d\u011Bt v klinick\u00FDch centrech s pat\u0159i\u010Dn\u00FDm z\u00E1zem\u00EDm." . "Endovascular treatment of acute thoracic aorta dissection and subsequent lower extremities ischemia"@en . "Situation: Insertion of tubular stentgrafts in the management of acute type B dissection of the thoracic aorta has recently become a popular alternative to open surgeries. The classical surgical procedure in complicated dissections is associated with mortality rates of up to 50% and prolonged intensive care hospitalisation. However, endovascular procedure have beeb associated with significantly lower morbidity and mortality rates. There is insufficient experience with the stentgraft implantation outcome concerning both the septum dissection and the lumini. Case review: A tubular stentgraft has been implanted to a forty-nine-year old patient with acute type B dissection. Immediate ischemic and neurological complications requiring reoperation and prolonged intensive care, where recorded postoperatively. The causes and the management are discussed. Conclusion: Endovascular management of the type B dissection is a popular, more patient-saving and healthcare professionals saving procedure, compared to classical open surgery. Pressure changes in the true and false aortic lumen may result in rapid reduction of the organ and limb perfusion flow. These complications should be expected and must be managed urgently. Such surgeries should be performed in clinical centres with appropriate facilities."@en . "Akutn\u00ED endovaskul\u00E1rn\u00ED \u0159e\u0161en\u00ED disekce hrudn\u00ED aorty a n\u00E1sledn\u00E9 isch\u00E9mie doln\u00EDch kon\u010Detin"@cs . "RIV/00023884:_____/08:#0002711!RIV12-MZ0-00023884" . . "[8FE0ABFBBF83]" . "3"^^ . "N" . . "Akutn\u00ED endovaskul\u00E1rn\u00ED \u0159e\u0161en\u00ED disekce hrudn\u00ED aorty a n\u00E1sledn\u00E9 isch\u00E9mie doln\u00EDch kon\u010Detin" . . . . . "1"^^ . . "355325" . . . . . "87" . "5"^^ .