cardiovascularКардиоваскулярная терапия и профилактикаCardiovascular Therapy and Prevention1728-88002619-0125«SILICEA-POLIGRAF» LLC10.15829/1728-8800-2021-3086cardiovascular-3086Research ArticleКЛИНИЧЕСКИЙ СЛУЧАЙCLINICAL CASEКлинический случай реканализации окклюзии инфраренального отдела аорты и стентирование по технике CulotteReconstruction of infrarenal abdominal aortic occlusion using the Culotte stenting technique: a case reporthttps://orcid.org/0000-0003-3851-4544ФещенкоД. А.FeshchenkoD. A.

Дарья Анатольевна Фещенко — младший научный сотрудник отдела инновационных эндоваскулярных методов профилактики и лечения сердечно-сосудистых заболеваний, врач рентгенэндоваскулярных методов диагностики и лечения, заведующий операционным блоком.

Москва. Тел.: +7 (985) 330-38-33

Moscow

dasha.feshenko@icloud.comhttps://orcid.org/0000-0003-2372-9788ЗасыпкинГ. С.ZasypkinG. S.

Георгий Сергеевич Засыпкин — врач-ординатор.

Москва

Moscow

artluzoria@gmail.comhttps://orcid.org/0000-0003-0346-9069РуденкоБ. А.RudenkoB. A.

Борис Александрович Руденко — доктор медицинских наук, врач рентгенэндоваскулярных методов диагностики и лечения, руководитель отдела инновационных эндоваскулярных методов профилактики и лечения сердечно-сосудистых заболеваний.

Москва

Moscow

brudenko@gnicpm.ruhttps://orcid.org/0000-0003-2602-5006ВасильевД. К.VasilievD. K.

Дмитрий Константинович Васильев — младший научный сотрудник отдела инновационных эндоваскулярных методов профилактики и лечения сердечно-сосудистых заболеваний, врач рентгенэндоваскулярных методов диагностики и лечения.

Москва

Moscow

dvasiliev@gnicpm.ruhttps://orcid.org/0000-0001-7307-1502ШукуровФ. Б.ShukurovF. B.

Фирдавс Баходурович Шукуров — врач рентгенэндоваскулярных методов диагностики и лечения.

Москва

Moscow

firshukurov@yahoo.comhttps://orcid.org/0000-0003-3119-6758ШаноянА. С.ShanoyanА. S.

Артем Сергеевич Шаноян — кандидат медицинских наук, заведующий отделением рентгенхирургических методов диагностики и лечения.

Москва

Moscow

ashanoyan@gnicpm.ruhttps://orcid.org/0000-0002-4453-8430ДрапкинаО. М.DrapkinaO. M.

Оксана Михайловна Драпкина — доктор медицинских наук, профессор, член-корр. РАН, директор.

Москва

Moscow

drapkina@bk.ruФГБУ Национальный медицинский исследовательский центр терапии и профилактической медицины Минздрава РоссииNational Medical Research Center for Therapy and Preventive Medicine20210801202220830863086Copyright © Фещенко Д.А., Засыпкин Г.С., Руденко Б.А., Васильев Д.К., Шукуров Ф.Б., Шаноян А.С., Драпкина О.М., 20222022Фещенко Д.А., Засыпкин Г.С., Руденко Б.А., Васильев Д.К., Шукуров Ф.Б., Шаноян А.С., Драпкина О.М.Feshchenko D.A., Zasypkin G.S., Rudenko B.A., Vasiliev D.K., Shukurov F.B., Shanoyan А.S., Drapkina O.M.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://cardiovascular.elpub.ru/jour/article/view/3086

Атеросклеротическое поражение инфраренального отдела аорты нередко встречается в клинической практике сосудистых и эндоваскулярных хирургов. В отсутствии своевременного лечения резко снижается трудоспособность и качество жизни пациентов, а в некоторых случаях пациенты обречены на проведение ампутации конечностей. До недавнего времени единственным вариантом лечения такого поражения являлось “открытое” хирургическое вмешательство. Однако хороший уровень подготовки эндоваскулярных хирургов и доступность инструментария позволяют сегодня выполнять малоинвазивные операции при данном виде поражения с сопоставимыми результатами по эффективности и с большей безопасностью для пациента в сравнении с открытой хирургией. Представляем клинический случай успешно выполненного эндоваскулярного лечения окклюзирующего поражения аорты с вовлечением правой и левой общих подвздошных артерий с применением бифуркационного стентирования по технике Culotte и результаты наблюдения за пациентом в течение 12 мес.

Patients with clinically significant infrarenal abdominal aortic atherosclerosis are often encountered in the clinical practice of vascular and endovascular surgeons. In the absence of timely treatment, the ability to work and life quality of patients are sharply reduced, and in some cases, patients require limb amputation. Until recently, the only treatment option for such a lesion was an open surgery. However, a good skill level of endovascular surgeons and the device availability allow today to perform minimally invasive operations with comparable effectiveness and greater safety in comparison with open surgery. We present a case report of successful endovascular treatment of aortic occlusion involving the right and left common and external iliac arteries using Culotte stenting technique with further 12-month follow-up.

клинический случай стентирования аортыэндоваскулярные вмешательстваокклюзия аортыCulotte-стентированиехроническая ишемия нижних конечностейcase report of aortic stent graftingendovascular interventionsaortic occlusionCulotte stentingchronic lower limb ischemiaReferencesPeach G, Griffin M, Jones KG, et al. Diagnosis and management of peripheral arterial disease. BMJ. 2012;345:e5208. doi:10.1136/bmj.e5208.Peach G, Griffin M, Jones KG, et al. Diagnosis and management of peripheral arterial disease. BMJ. 2012;345:e5208. doi:10.1136/bmj.e5208.Чигидинова Д. С., Руденко Б. А., Шаноян А. С. и др. Эндоваскулярное лечение острого тромбоза тибиопероне-ального ствола. Клинический случай. Креативная хирургия и онкология. 2019;9(2):113-7 doi:10.24060/2076-3093-2019-9-2-113-117Chigidinova DS, Rudenko BA, Shanoyan AS, et al. Endovascular Treatment of Acute Tibioperoneal Trunk Thrombosis. A Clinical Case Report. Creative surgery and oncology. 2019;9(2):113-7. (In Russ.) doi:10.24060/2076-3093-2019-9-2-113-117Aboyans V, Ricco JB, Bartelink MEL, et al. 2017 ESC Guidelines on the Diagnosis and Treatment of Peripheral Arterial Diseases, in collaboration with the European Society for Vascular Surgery (ESVS): Document covering atherosclerotic disease of extracranial carotid and vertebral, mesenteric, renal, upper and lower extremity arteries Endorsed by: the European Stroke Organization (ESO) The Task Force for the Diagnosis and Treatment of Peripheral Arterial Diseases of the European Society of Cardiology (ESC) and of the European Society for Vascular Surgery (ESVS). Eur Heart J. 2018;39(9):763-816. doi:10.1093/eurheartj/ehx095.Aboyans V, Ricco JB, Bartelink MEL, et al. 2017 ESC Guidelines on the Diagnosis and Treatment of Peripheral Arterial Diseases, in collaboration with the European Society for Vascular Surgery (ESVS): Document covering atherosclerotic disease of extracranial carotid and vertebral, mesenteric, renal, upper and lower extremity arteries Endorsed by: the European Stroke Organization (ESO) The Task Force for the Diagnosis and Treatment of Peripheral Arterial Diseases of the European Society of Cardiology (ESC) and of the European Society for Vascular Surgery (ESVS). Eur Heart J. 2018;39(9):763-816. doi:10.1093/eurheartj/ehx095.Norgren L, Hiatt WR, Dormandy JA, et al. Inter-Society Consensus for the Management of Peripheral Arterial Disease (TASC II). J Vasc Surg. 2007;45 Suppl S:S5-67. doi: 10.1016/j.jvs.2006.12.037.Norgren L, Hiatt WR, Dormandy JA, et al. Inter-Society Consensus for the Management of Peripheral Arterial Disease (TASC II). J Vasc Surg. 2007;45 Suppl S:S5-67. doi: 10.1016/j.jvs.2006.12.037.TASC Steering Committee, Jaff MR, White CJ, et al. An Update on Methods for Revascularization and Expansion of the TASC Lesion Classification to Include Below-the-Knee Arteries: A Supplement to the Inter-Society Consensus for the Management of Peripheral Arterial Disease (TASC II). Vasc Med. 2015;20(5):465-78. doi:10.1177/1358863X15597877.TASC Steering Committee, Jaff MR, White CJ, et al. An Update on Methods for Revascularization and Expansion of the TASC Lesion Classification to Include Below-the-Knee Arteries: A Supplement to the Inter-Society Consensus for the Management of Peripheral Arterial Disease (TASC II). Vasc Med. 2015;20(5):465-78. doi:10.1177/1358863X15597877.Tepe G, Schnorr B, Albrecht T, et al. Angioplasty of femoral-popliteal arteries with drug-coated balloons: 5-year follow-up of the THUNDER trial. JACC Cardiovasc Interv. 2015;8(1 Pt A):102-8. doi:10.1016/j.jcin.2014.07.023.Tepe G, Schnorr B, Albrecht T, et al. Angioplasty of femoral-popliteal arteries with drug-coated balloons: 5-year follow-up of the THUNDER trial. JACC Cardiovasc Interv. 2015;8(1 Pt A):102-8. doi:10.1016/j.jcin.2014.07.023.Scheinert D, Katsanos K, Zeller T, et al. A prospective randomized multicenter comparison of balloon angioplasty and infrapopliteal stenting with the sirolimus-eluting stent in patients with ischemic peripheral arterial disease: 1-year results from the ACHILLES trial. J Am Coll Cardiol. 2012;60(22):2290-5. doi: 10.1016/j.jacc.2012.08.989.Scheinert D, Katsanos K, Zeller T, et al. A prospective randomized multicenter comparison of balloon angioplasty and infrapopliteal stenting with the sirolimus-eluting stent in patients with ischemic peripheral arterial disease: 1-year results from the ACHILLES trial. J Am Coll Cardiol. 2012;60(22):2290-5. doi: 10.1016/j.jacc.2012.08.989.Spanos K, Antoniou GA, Saleptsis V, et al. Hybrid procedures for chronic lower limb ischemia: what determines the outcome? Int Angiol. 2017; 36(2):174-81.Spanos K, Antoniou GA, Saleptsis V, et al. Hybrid procedures for chronic lower limb ischemia: what determines the outcome? Int Angiol. 2017; 36(2):174-81.Teraa M, Conte MS, Moll FL, Verhaar MC. Critical Limb Ischemia: Current Trends and Future Directions. J Am Heart Assoc. 2016;5(2):e002938. doi:10.1161/JAHA.115.002938.Teraa M, Conte MS, Moll FL, Verhaar MC. Critical Limb Ischemia: Current Trends and Future Directions. J Am Heart Assoc. 2016;5(2):e002938. doi:10.1161/JAHA.115.002938.Leville CD, Kashyap VS, Clair DG, et al. Endovascular management of iliac artery occlusions: extending treatment to TransAtlantic Inter-Society Consensus class C and D patients. J Vasc Surg. 2006;43(1):32-9. doi:10.1016/j.jvs.2005.09.034.Leville CD, Kashyap VS, Clair DG, et al. Endovascular management of iliac artery occlusions: extending treatment to TransAtlantic Inter-Society Consensus class C and D patients. J Vasc Surg. 2006;43(1):32-9. doi:10.1016/j.jvs.2005.09.034.Society for Vascular Surgery Lower Extremity Guidelines Writing Group, Conte MS, Pomposelli FB, et al. Society for Vascular Surgery practice guidelines for atherosclerotic occlusive disease of the lower extremities: management of asymptomatic disease and claudication [published correction appears in J Vasc Surg. 2015;61(5):1382]. J Vasc Surg. 2015;61 (3 Suppl):2S-41. doi:10.1016/j.jvs.2014.12.009.Society for Vascular Surgery Lower Extremity Guidelines Writing Group, Conte MS, Pomposelli FB, et al. Society for Vascular Surgery practice guidelines for atherosclerotic occlusive disease of the lower extremities: management of asymptomatic disease and claudication [published correction appears in J Vasc Surg. 2015;61(5):1382]. J Vasc Surg. 2015;61 (3 Suppl):2S-41. doi:10.1016/j.jvs.2014.12.009.Taeymans K, Groot Jebbink E, Holewijn S, et al. Three-year outcome of the covered endovascular reconstruction of the aortic bifurcation technique for aortoiliac occlusive disease. J Vasc Surg. 2018;67(5):1438-47. doi:10.1016/j.jvs.2017.09.015.Taeymans K, Groot Jebbink E, Holewijn S, et al. Three-year outcome of the covered endovascular reconstruction of the aortic bifurcation technique for aortoiliac occlusive disease. J Vasc Surg. 2018;67(5):1438-47. doi:10.1016/j.jvs.2017.09.015.Bismuth J. Iliac Intervention and Management of the Challenging Bifurcation and Distal EIA. J EvToday. 2019;18(1):57-60.Bismuth J. Iliac Intervention and Management of the Challenging Bifurcation and Distal EIA. J EvToday. 2019;18(1):57-60.Sherif M. Angioplasty and stenting for peripheral arterial disease of the lower limbs. E-Journal of Cardiology Practice. 2018;16(8).Sherif M. Angioplasty and stenting for peripheral arterial disease of the lower limbs. E-Journal of Cardiology Practice. 2018;16(8).Rutherford RB, Baker JD, Ernst C, et al. Recommended standards for reports dealing with lower extremity ischemia: revised version [published correction appears in J Vasc Surg. 2001;33(4):805]. J Vasc Surg. 1997;26(3):517-38. doi:10.1016/s0741-5214(97)70045-4.Rutherford RB, Baker JD, Ernst C, et al. Recommended standards for reports dealing with lower extremity ischemia: revised version [published correction appears in J Vasc Surg. 2001;33(4):805]. J Vasc Surg. 1997;26(3):517-38. doi:10.1016/s0741-5214(97)70045-4.Feldman DN, Armstrong EJ, Aronow HD, et al. SCAI guidelines on device selection in Aorto-Iliac arterial interventions. Catheter Cardiovasc Interv. 2020;96(4):915-29. doi: 10.1002/ccd.28947Feldman DN, Armstrong EJ, Aronow HD, et al. SCAI guidelines on device selection in Aorto-Iliac arterial interventions. Catheter Cardiovasc Interv. 2020;96(4):915-29. doi: 10.1002/ccd.28947Brittenden J, Beattie G, Bradbury AW. Outcome of iliac kissing stents. Eur J Vasc Endovasc Surg. 2001;22(5):466-8. doi:10.1053/ejvs.2001.1481.17 Brittenden J, Beattie G, Bradbury AW. Outcome of iliac kissing stents. Eur J Vasc Endovasc Surg. 2001;22(5):466-8. doi:10.1053/ejvs.2001.1481.Scheinert D, Schroder M, Balzer JO, et al. Stent-supported reconstruction of the aortoiliac bifurcation with the kissing balloon technique. Circulation. 1999; 100( 19 Suppl):II295-300. doi:10.1161/01.cir.100.suppl_2.ii-295.Scheinert D, Schroder M, Balzer JO, et al. Stent-supported reconstruction of the aortoiliac bifurcation with the kissing balloon technique. Circulation. 1999; 100( 19 Suppl):II295-300. doi:10.1161/01.cir.100.suppl_2.ii-295.Moon JY, Hwang HP, Kwak HS, et al. The Results of SelfExpandable Kissing Stents in Aortic Bifurcation. Vasc Specialist Int. 2015;31(1):15-9. doi:10.5758/vsi.2015.31.1.15.Moon JY, Hwang HP, Kwak HS, et al. The Results of SelfExpandable Kissing Stents in Aortic Bifurcation. Vasc Specialist Int. 2015;31(1):15-9. doi:10.5758/vsi.2015.31.1.15.Mwipatayi BP, Thomas S, Wong J, et al. Durability of the balloon-expandable covered versus bare-metal stents in the Covered versus Balloon Expandable Stent Trial (COBEST) for the treatment of aortoiliac occlusive disease. J Vasc Surg. 2016;64:83-94. doi:10.1016/j.jvs.2016.02.064.Mwipatayi BP, Thomas S, Wong J, et al. Durability of the balloon-expandable covered versus bare-metal stents in the Covered versus Balloon Expandable Stent Trial (COBEST) for the treatment of aortoiliac occlusive disease. J Vasc Surg. 2016;64:83-94. doi:10.1016/j.jvs.2016.02.064.Sharafuddin MJ, Hoballah JJ, Kresowik TF, Sharp WJ. Kissing stent reconstruction of the aortoiliac bifurcation. Perspect Vasc Surg Endovasc Ther. 2008;20(1):50-60. doi:10.1177/1531003507313224.Sharafuddin MJ, Hoballah JJ, Kresowik TF, Sharp WJ. Kissing stent reconstruction of the aortoiliac bifurcation. Perspect Vasc Surg Endovasc Ther. 2008;20(1):50-60. doi:10.1177/1531003507313224.Adriaenssens T, Byrne RA, Dibra A, et al. Culotte stenting technique in coronary bifurcation disease: angiographic follow-up using dedicated quantitative coronary angiographic analysis and 12-month clinical outcomes. Eur Heart J. 2008;29(23):2868-76. doi:10.1093/eurheartj/ehn512.Adriaenssens T, Byrne RA, Dibra A, et al. Culotte stenting technique in coronary bifurcation disease: angiographic follow-up using dedicated quantitative coronary angiographic analysis and 12-month clinical outcomes. Eur Heart J. 2008;29(23):2868-76. doi:10.1093/eurheartj/ehn512.

The authors declare that there are no conflicts of interest present.