Endoluminal technique for aortic constriction

Recently, the Department of Vascular Surgery of the Fifth Affiliated Hospital of Zheng University successfully cured a patient with aortic constriction by applying the latest endovascular treatment. The patient, a 40-year-old male, was treated for intermittent palpitations, chest tightness and precordial discomfort at several hospitals in the province, but all were treated for heart disease with poor results. The patient was referred to the Department of Vascular Surgery of the Fifth Affiliated Hospital of Zheng University. Upon admission, it was found that the arterial pulsation of the lower extremities could not be palpated, the blood pressure of the lower extremities could not be measured, and a vascular murmur could be heard on auscultation in the clavicular region, so the diagnosis of aortic constriction was suspected. Aortic constriction is a congenital disease with a low incidence, manifested as a severe narrowing of the diameter of the junction of the aortic arch and descending aorta, which prevents the blood from the heart from flowing smoothly downward, resulting in insufficient blood supply to the lower extremities and elevated blood pressure in the upper extremities and head, which may lead to heart failure, cerebrovascular accidents and ischemic diseases of the lower extremities if not treated in time, seriously threatening the health and life safety of patients. The diagnosis rate of this disease is low, and many hospitals are not sufficiently aware of it, and it is mostly misdiagnosed as heart disease and hypertension, so that many patients do not receive effective diagnosis and treatment. The patient’s diagnosis of aortic constriction was confirmed by CTA examination of the thoracic aorta. The thoracic aorta was strangled as if by a rope, forming a shape similar to the number “3”, while the left subclavian artery and the lower thoracic aorta were dilated. According to Dr. Wang Bing, chief physician of the Department of Vascular Surgery of the Fifth Affiliated Hospital of Zheng University, the balloon was a BIB technique, that is, Balloon InBalloon, which is a balloon inside a balloon, and the stent was a CP stent, that is, a platinum-iridium alloy overlay stent over the balloon. Through the pre-dilation of the first small balloon and the expansion of the second large balloon, the narrowing of the aorta is lifted, while the stent is positioned at the narrowing, which provides continuous support and solves the problem once, with a very low restenosis rate, which is the latest and most reasonable technique for the treatment of aortic narrowing at present. Previously, the treatment of this disease was mainly open-heart aortic repair, which was more traumatic, with high mortality, pain and long hospitalization period, which seriously limited the development of this procedure. In recent years, the Fifth Affiliated Hospital of Zhengzhou University has been the first in the province to carry out the endoluminal treatment of aortic narrowing, which is less traumatic, less painful, faster recovery, lower cost and lower recurrence rate, and has achieved excellent results. The patient had a clear diagnosis and typical symptoms, and was hospitalized and treated with endoluminal surgery on the second day after active preoperative preparation. A small incision was made at the root of the patient’s right thigh to find the femoral artery, which was punctured, and a thin guidewire was passed through the abdominal aorta, the lower segment of the thoracic aorta, through the aortic constriction, and into the ascending aorta under intraoperative DSA surveillance. A double balloon with an overlapping stent was entered along the guidewire and placed at the aortic constriction. The first small balloon was pre-dilated, and then the large balloon was dilated, and the stent was successfully applied to the aortic stenosis, and the aortic constriction was released by re-imaging. The device was withdrawn, the wound was sutured, and the procedure was completed, taking less than one hour for the entire procedure. The patient’s palpitations, chest tightness, and precordial discomfort disappeared soon after the operation, and arterial pulsations in the lower extremities could be palpated. At present, the patient has left bed and is feeling well. According to Dr. Wang Bing, chief physician of the Department of Vascular Surgery of the Fifth Affiliated Hospital of Zheng University, the balloon was a BIB technique, that is, Balloon InBalloon, which is a balloon inside a balloon, and the stent was a CP stent, that is, a platinum-iridium alloy overlay stent over the balloon. Through the pre-expansion of the first small balloon and the expansion of the second large balloon, the narrowing of the aorta is lifted, while the stent is positioned at the narrowing, which has the effect of continuous support, solving the problem once, and the restenosis rate is extremely low, which is the latest and most reasonable technology for the treatment of aortic narrowing at present.