Related Experiment Video
Updated: Jul 8, 2025
Novel and Innovative Hybrid Technique for Type A Aortic Dissection
Published on: March 28, 2025
Case study scrub nurse role in aorto-bifemoral reconstruction with transbrachial balloon endoclamping technique
Jasna Racic1, Slobodan Pesic1, Zorka Nikolic1
1Vascular Surgery Clinic, "Dedinje" Cardiovascular Institute, Heroja Milana Tepića 1 street, Belgrade 11000, Serbia.
Insights
A novel hybrid surgical approach successfully treated severe aortoiliac arterial disease in a high-risk patient. This technique utilized endovascular aortic occlusion during aortobifemoral reconstruction, proving safe and effective.
Area of Science:
- Vascular Surgery
- Interventional Cardiology
- Radiology
Background:
- Aortoiliac arterial disease involves progressive narrowing of the aorta and iliac arteries, often requiring aortobifemoral reconstruction.
- Circumferential juxtarenal aortic calcification presents significant intraoperative risks during standard open repair due to challenging cross-clamping.
- Endovascular techniques offer potential solutions for complex aortic pathologies.
Introduction:
Aortoiliac arterial disease is a chronic progressive disease which is characterized by steno-occlusive changes in the aorta and iliac arteries. The gold standard for the treatment of patients with the advanced stage of the disease is aorto-bifemoral reconstruction. Patients with circumferential juxtarenal calcifications of the aorta bear a high risk of intraoperative complications, due to difficult cross-clamping in such zones.
Case Report:
We present a case of a 73-year-old patient who has been admitted due to left leg rest pain and second toe ulceration. Multislice computed tomography showed significant stenosis of the aortoiliac segment with a circumferentially calcified abdominal aorta. Aortobifemoral reconstruction was performed featuring endoluminal occlusion of the aorta using a balloon catheter which was placed through the left brachial artery. The procedure and the postoperative course were uneventful, and the patient was discharged on the sixth postoperative day.
Conclusion:
The hybrid endovascular and open surgery technique presented emerged as a valid alternative for selected high-risk patients. Scrub nurses should be familiarized with endovascular techniques and tools and be aware of the measures to be protected from the harmful effects of ionizing radiation.
