Biomedical subjects
Publications and source records attributed to F Robicsek.
A method consisting of direct transaneurysmal insertion of a double lumen balloon catheter designed to gain control of the inflow into ruptured or difficult to dissect aneurysms is presented.
It is considered good surgical practice to cleanse the aorta and the vascular prosthesis of debris in aorto-iliac reconstruction by a "downward flush" through the unanastomosed end of the prosthesis, thus prevent the development "trash foot" caused by distal embolization. A method is presented which by applying a filtering device allows the flushed blood to enter the distal arterial tree instead of being discarded, thus allowing the prolongation of the maneuver and the increase of its effectiveness.
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The authors discuss in general, conservative surgical therapy in the management of thoracic aneurysms and the principle that the purpose of such surgery is to prevent rupture and not "extirpation of a tumor". As an illustrative example, they present a case in which a large thoracoabdominal aneurysm was managed by bypass exclusion and individual grafting of the visceral arteries and-in the same patient-two aneurysms of the ascending aorta and aortic regurgitation caused by dissection were handled by valve suspension, limited resection, and external grafting. They promote the usage of conservative procedures versus radical resection in selected cases of aortic aneurysms as an effective alternate.
The case of a middle-aged woman with an extensive thoraco-abdominal aneurysm who underwent exclusion-bypass grafting (Hardy procedure) is presented. The patient had an uneventful recovery. Studies one year after surgery showed all grafts to be well functioning and the aneurysm thrombosed. In the authors' opinion, the method is a valuable alternative to more radical operations designed for treatment of thoraco-abdominal aneurysm.