Ukrainian Interventional Neuroradiology and Surgery最新文献

{"title":"Stenting of ultraembolic hazardous carotid stenotic lesions using the technique of triple antiembolic protection","authors":"Y. Cherednichenko, M. Zorin, A.Yu Miroshnichenko, N. Cherednichenko","doi":"10.26683/2786-4855-2021-2(36)-14-24","DOIUrl":"https://doi.org/10.26683/2786-4855-2021-2(36)-14-24","url":null,"abstract":"Objective ‒ to develop a technique of triple antiembolic protection with the simultaneous use of proximal antiembolic protection systems, distal antiembolic filters and two-layer micromesh carotid stents for carotid stenting of ultraembolic hazardous carotid stenosis. Evaluate its effectiveness and safety.Materials and methods. Since 2016, 23 carotid stenting of ultraembolic hazardous carotid stenoses has been performed using the technique of triple antiembolic protection (proximal antiembolic protection systems, distal antiembolic filters and two-layer micromesh carotid stents). All patients had symptomic stenosis: transient ischemic attacks in a certain carotid pool (n = 7), ischemic strokes (n = 16). The age of patients was from 57 to 84 years. Men prevailed among patients (n = 15). Postoperative follow-up included magnetic resonance imaging (MRI) of the brain on the first or second day after surgery with T2*, FLAIR and DWI sequences to determine the presence of «fresh» embolic ischemic foci and to exclude hemorrhagic complications. After 6 months, a control clinical examination, computed tomography or MRI of the brain, ultrasound angioscanning of the main arteries of the head were performed.Results. In all patients the patency of the carotid arteries was completely restored, and in the early postoperative period, no clinical signs of recurrent ischemic brain damage were detected in any of the cases. No signs of plaque prolapse through the stent were detected in any case. A significant amount of atheromatous debris was in 11 cases when aspirated on an external filter. In 3 cases, emboli were also detected in the distal protection filter. This fact indicates that the joint use of distal and proximal antiembolic systems reliably protects against the risk of embolism in such cases. According to MRI on the 1st or 2nd day there were no signs of «fresh» subclinical embolic ischemic foci, as well as hemorrhage. In 20 patients who underwent a follow-up examination, no signs of restenosis in the stent were recorded in any case, as well as repeated ischemic strokes. In 7 cases where the plaque had an ulcer, the ulcer resolved under the stent. Three patients are expected for a follow-up examination. According to the remote survey, these patients do not have new ischemic brain lesions. The effectiveness of the technique of triple antiembolic protection for the treatment of patients with subtotal ultraembolic hazardous carotid stenosis is indicated by the absence of clinical and neuroradiological signs of recurrent ischemic lesions.Conclusions. The technique of triple antiembolic protection for the treatment of patients with subtotal ultraembolic hazardous carotid stenoses is safe and highly effective. It is the improvement of carotid stenting results in this most dangerous group that gives reason to think about revealing the advantages of carotid stenting over carotid endarterectomy in general.","PeriodicalId":325397,"journal":{"name":"Ukrainian Interventional Neuroradiology and Surgery","volume":"44 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116311665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The approach to the management of a patient with chronic venous insufficiency in a specialized vascular center ‒ a combination of world guidelines and personal experience","authors":"O. Voloshyn, O. Suzdalenko, V. Gubka, S. Machuskyi, O. Popova, S. Rasulzade","doi":"10.26683/2786-4855-2021-2(36)-60-72","DOIUrl":"https://doi.org/10.26683/2786-4855-2021-2(36)-60-72","url":null,"abstract":"A lot of recommendations has been published regarding the treatment of chronic venous disease. At the same time, none of these documents reflects the complete «path» of the patient from the stage of the initial visit (diagnosis) to the choice of the optimal treatment option. Therefore, the creation of a protocol that would take into account on the one hand the most modern and proven effective approaches to diagnosis and treatment, and on the other hand, the individual characteristics of each clinical case is an urgent task.The main task of the publication is to create a practice-oriented instruction for the diagnosis, comprehensive treatment and prevention of chronic venous insufficiency. The management of a patient with chronic venous insufficiency is presented in the form of «AngioLife Venous Protocol®», a set of clear practical recommendations for vascular surgeon and phlebologist. This protocol is based on our own practical experience, existing protocols and guidelines for the treatment of patients with chronic venous insufficiency. The venous protocol includes four stages of a set of medical measures, the purpose of which is to form a clear program of further examination and treatment of the patient. Adherence to all the recommendations specified in the protocol allows to obtain satisfactory functional and cosmetic results of treatment of patients with chronic venous insufficiency with minimal risk of recurrence.","PeriodicalId":325397,"journal":{"name":"Ukrainian Interventional Neuroradiology and Surgery","volume":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116633227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neurological and medical complications in cerebral stroke patients before hospitalization and during admission to the clinic «oberig» stroke center","authors":"Y. Flomin","doi":"10.26683/2786-4855-2021-1(35)-14-25","DOIUrl":"https://doi.org/10.26683/2786-4855-2021-1(35)-14-25","url":null,"abstract":"Objective ‒ to determine the rate of medical and neurological complications in patients with cerebral stroke (CS) before hospitalization and during in-patient treatment at the Stroke Center (SC), as well as to establish independent predictors for new medical complications at the SC, and to develop an appropriate prognostic model. Materials and methods. The study enrolled 539 patients, 309 (57.3 %) were men and 230 (42.7 %) were women. The age of patients ranged from 20.4 to 95.6 (66.0 [57.9; 75.1]) years. 438 (81.3 %) patients were diagnosed with ischemic stroke (177 (40.4%) ‒ atherothrombotic subtype, 200 (45.7 %) ‒ cardioembolic, 30 (6.9 %) – lacunar, 32 (7.0 %) ‒ stroke of other established or undetermined etiology), 101 (18.7 %) ‒ intracerebral hemorrhage. 109 (20.2%) of the study participants were hospitalized in the hyperacute period, 113 (21.0 %) ‒ in the acute, 199 (36.9 %) ‒ in the early subacute, 36 (6.7 %) ‒ in the late subacute, 82 (15.2%) ‒ in the remote (chronic) period of CS. All patients were evaluated upon admission using the National Institutes of Health Stroke Scale (NIHSS) and the modified Rankin Scale (mRS). The method of construction and analysis of logistic regression models was used to quantify the degree of influence of factor features on the risk of complications. The analysis was performed using the package MedCalc v. 19.1. Results. The total NIHSS score on admission ranged from 0 to 39 (11 [6; 18]). Among the studied patients, 119 (22.1 %) had mild, 218 (40.5 %) – moderate, 114 (21.2 %) – severe, 88 (16.3 %) – very severe CS. Asesed with mRS upon admission, 11 (2.0 %) patients have 0 point, 34 (6.3 %) – 1 point, 58 (10.8 %) – 2 point, 65 (12.1 %) – 3 point,136 (25.2 %) – 4 point, and 235 (43.6 %) – 5 point. Neurological or medical complications before hospitalization occurred in 303 (56.2 %) patients, including 111 (20.6 %) patients with neurological complications and 192 (35.6 %) patients with medical ones. More than one complication was recorded in 52 (9.6 %) persons. The incidence of new neurological and medical complications during the SC stay was significantly lower (p<0.001) than before hospitalization. The independent predictors of new medical complications were CE subtype of IS (OR 2.08; 95 % CI 1.11–3.92), medical complications before admission (OR 2.58; 95 % CI 1.51–4.42), higher initial NIHSS score (OR 1.11; 95 % CI 1.06–1.16 for each additional point), and higher initial mRS (OR 1.62; 95 % CI 1.07–2.48, for each additional point). The predictive model based on the selected set of features has good sensitivity (86.4 %) and moderate specificity (68.4 %). The area under the operating characteristics curve AUC = 0.85 (95 % CI 0.82–0.88), indicates a strong relationship between this set of factorial factors and the risk of medical complications during in-patient treatment at the SC. Conclusions. Before SC admission, complications, mainly medical, occurred in the majo-rity of the patients. A higher rate of medica","PeriodicalId":325397,"journal":{"name":"Ukrainian Interventional Neuroradiology and Surgery","volume":"43 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126956361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biophysical mechanisms of the formation of wound channels in non-penetrating gunshot craniocerebral wounds","authors":"A.O. Danchyn, O. Goncharuk, S. Usatov, M.S. Altabury, G.O. Danchyn","doi":"10.26683/2786-4855-2021-1(35)-33-42","DOIUrl":"https://doi.org/10.26683/2786-4855-2021-1(35)-33-42","url":null,"abstract":"Objective ‒ to develop recommendations for optimization of primary surgical treatment of gunshot penetrating craniocerebral wounds on the basis of theoretical and applied study of one of the sections of wound ballistics ‒ biophysical mechanisms of wound canal formation, concomitant impenetrable wounds and intracranial injuries.Materials and methods. The medical histories of 155 wounded who received a non-pe-netrating craniocerebral injury during the hostilities in the East of Ukraine in 2014‒2020 were studied. All of the wounded were males between 18 and 60 years old (mean age ‒ 35.1 years). To study the biophysical features of the formation of different types of wound canals at a given non-lethal kinetic energy transferred to the head tissues, the type of the wounding projectile, the flight trajectory, the nature of gunshot injuries to the soft tissues of the cranial vault and skull fractures and intracranial injuries were determined according to the data of clinical stu-dies and computed tomography and compared with the results of theoretical studies using the laws of wound ballistics.Results. There were 11 (7.1 %) bullet (only tangential) wounds, and 144 (92.9 %) shrapnel. The formation of wound channels depends on the type of the wounding projectile and its kinetic energy. Non-penetrating firearms bullet and shrapnel tangential craniocerebral wounds are caused by the destructive effect of injuring shells on the tissues, which at the moment of collision with the head have both destructive kinetic energy (>80 J) and less than destructive kinetic energy. Blind craniocerebral injuries are caused only by the traumatic effects of fragments with a small (<80 J) kinetic energy.Conclusions. With gunshot non-penetrating single shrapnel blind wounds, the wounds do not have a zone of secondary necrosis, and the zone of primary necrosis is small or insignificant, which makes it possible not to carve soft tissues around the wound during primary surgical treatment, but only to remove necrotic tissues. With gunshot non-penetrating shrapnel tangential and blind craniocerebral wounds, when the soft tissue wounds of the cranial vault do not gap, small size (damage to the skin, subcutaneous tissue to aponeurosis), primary surgical treatment is not performed. Such wounds are treated with a toilet and aseptic dressings. Wound canals ending in gunshot fractures are subject to primary surgical treatment in the same way as gunshot fractures.","PeriodicalId":325397,"journal":{"name":"Ukrainian Interventional Neuroradiology and Surgery","volume":"62 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115372480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Free-floating thrombus and a fragment of atherosclerotic plaque in the lumen of the internal carotid artery – review of 2 cases","authors":"S. Konotopchyk, F. H. Rzayeva, O. Pastushyn, N. M. Nosenko, O.Ye. Svyrydiuk, M. Mamonova, I. Al-Kashkish","doi":"10.26683/2786-4855-2021-1(35)-56-65","DOIUrl":"https://doi.org/10.26683/2786-4855-2021-1(35)-56-65","url":null,"abstract":"Free-floating thrombus or a fragment of atherosclerotic plaque (mobile plaque) in the lumen of the carotid artery is extremely rare. Atherosclerosis is the most common cause underlying their occurrence. The optimal treatment strategy has not been developed, at least in part due to the rarity of observations, as well as the lack of comparative studies between conservative and surgical treatment (carotid artery stenting, endovascular thrombectomy, endarterectomy). We present two cases that demonstrate the treatment tactics of these rather rare pathologies. Patient Yu., 62 years old, was hospitalized with focal neurological symptoms, National Institutes of Health Stroke Scale of 12. According to the CT of the brain, signs of an ischemic stroke in the right middle cerebral artery circulation were detected. Selective cerebral angiography diagnosed thrombosis of the arteries of the precentral and central sulcus of the right middle cerebral artery, critical stenosis of the mouth of the right internal carotid artery, and a free-floating thrombus in its lumen with a fixation point at the level of atherosclerotic plaque, which blocked the lumen of the artery by more than 60 %. Endovascular aspiration of a free-floating thrombus was performed, followed by angioplasty and stenting of critical stenosis with a favorable clinical outcome. Patient L., 73 years old, applied for carotid ultrasonography, during which a mobile atherosclerotic plaque was diagnosed at the level of the bifurcation of the right common carotid artery. Digital selective cerebral angiography confirmed a plaque fragment floating in the lumen of the artery. After applying a loading dose of ticagrelor without complications, an emergency implantation of a carotid stent was performed at the level of the bifurcation of the right common carotid artery.Taking into account the modern possibilities of interventional radiology and a wide range of tools, the endovascular approach to the treatment of complicated atherosclerotic plaque with a floating component or a formed blood clot is the best treatment option with a good safety profile.","PeriodicalId":325397,"journal":{"name":"Ukrainian Interventional Neuroradiology and Surgery","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114519737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiosurgical treatment of residual and recurrent pituitary adenomas","authors":"O. Voznyak, O. S. Silaieva, M. Polishchuk, N. Hryniv","doi":"10.26683/2786-4855-2021-1(35)-26-32","DOIUrl":"https://doi.org/10.26683/2786-4855-2021-1(35)-26-32","url":null,"abstract":"Objective ‒ the treatment result estimation of subtotally removed and recurrent pituitary adenomas using different algorithms of radiotherapy and radiosurgery.Materials and methods. The retrospective analysis of 21 cases of pituitary adenomas was performed. There were 11 women and 10 men included. The average age was 45 (from 18 to 72) years. All patients had relapse or residual tumor after incomplete surgical removal. The method of irradiation was chosen by a radiologist. Tumor size control was assessed by an independent radiologist in 3 months and 1 year after treatment. Endocrine function was estimated by an independent endocrinologist in 3 months and 1 year after treatment.Results. Following transsphenoidal removal ‒ 13 patients (4 were operated twice), 5 after cranial surgery and 3 were operated sequentially transnasally and transcranially. Irradiation of 14 cases of residual tumor was performed no later than 6 months after surgery. The mean term of treatment start of recurrent adenomas was 12 months (8‒17) after surgery. VARIAN Novalis was applied in 16 cases, VARIAN Clinac iX in 4 cases and VARIAN TrueBeam STx was used once. Single and total radiation doses were determined individually. None of patients had visual impairment after treatment. The hypopituitarism deterioration was not noted as well.Conclusions. Hypofractionated stereotactic radiosurgery allows to bring a high dose of radiation to the pituitary adenomas, minimizing damage to the visual pathways, the pituitary gland and infundibulum. As the sequence, it reduces the toxicity of the technique. The application of modern radiation technologies minimize the irradiation of healthy surrounding tissues and reduce the negative effects of treatment.","PeriodicalId":325397,"journal":{"name":"Ukrainian Interventional Neuroradiology and Surgery","volume":"36 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122872079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Possibility of increasing the «therapeutic window» for revascularization of the carotid arteries in the acute period of ischemic stroke","authors":"O. Spinul, O. Kartashov, O.O. Shpak","doi":"10.26683/2786-4855-2021-1(35)-43-49","DOIUrl":"https://doi.org/10.26683/2786-4855-2021-1(35)-43-49","url":null,"abstract":"Objective ‒ to assess the possibility of increasing the time of surgical restoration of blood flow in the acute period of ischemic stroke due to occlusive lesion of the internal carotid artery (ICA).Materials and methods. Among the patients who were admitted for treatmentat in the Regional Odessa Hospital with acute ischemic stroke in the carotid region a group of 6 patients was identified in whom the cause of stroke was occlusion of the ICA by an atherosclerotic plaque. Age of patients ‒ from 54 to 71 years. Patients were hospitalized later 6 hours from the onset of stroke. The survey was carried out according to the established protocol. Neurological deficits are mild to moderate. In order to eliminate the occlusion of the ICA, all patients underwent endarterectomy.Results. Carotidendarterectomy was performed from 2 to 11 days after onset of stroke. Retrograde blood flow through the ICA was obtained in three (50 %) patients in whom surgical interventions were performed up to 4 days after the disease. In the postoperativeperiod a typical therapy was carried out. In cases with the obtained retrograde blood flowon control carotid angiograms demonstrated revascularization of the ICA basin according to mTICI-3. On the control CT of the brain in postoperative period in one case the point subarachnoid hemorrhages was determined. In the other two cases there was no evidence hemorrhagic transformation. Operated patients showed positive dynamics: a decrease hemiparesis by 1 poin and regression of mental disorders. The patients were discharged withm RS 1‒2. During the follow-up examination 90 days the neurological condition of the patients improved to mRS 1‒0.Conclusions. Results obtained in increasing the “therapeutic window” for revascularization of the occluded ICA allow to continue research in the indicated direction and improve the quality of surgical care for patients with acute stroke.","PeriodicalId":325397,"journal":{"name":"Ukrainian Interventional Neuroradiology and Surgery","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122635919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"To the issue of degree of removal of gliomas of supratentorial localization","authors":"S. Usatov, B. Rashidi, Y. Boguslavskiy","doi":"10.26683/2786-4855-2021-1(35)-50-55","DOIUrl":"https://doi.org/10.26683/2786-4855-2021-1(35)-50-55","url":null,"abstract":"Objective ‒ to assess the possibility of increasing the time of surgical restoration of blood flow in the acute period of ischemic stroke due to occlusive lesion of the internal carotid artery (ICA).Materials and methods. Among the patients who were admitted for treatmentat in the Regional Odessa Hospital with acute ischemic stroke in the carotid region a group of 6 patients was identified in whom the cause of stroke was occlusion of the ICA by an atherosclerotic plaque. Age of patients ‒ from 54 to 71 years. Patients were hospitalized later 6 hours from the onset of stroke. The survey was carried out according to the established protocol. Neurological deficits are mild to moderate. In order to eliminate the occlusion of the ICA, all patients underwent endarterectomy.Results. Carotidendarterectomy was performed from 2 to 11 days after onset of stroke. Retrograde blood flow through the ICA was obtained in three (50 %) patients in whom surgical interventions were performed up to 4 days after the disease. In the postoperativeperiod a typical therapy was carried out. In cases with the obtained retrograde blood flowon control carotid angiograms demonstrated revascularization of the ICA basin according to mTICI-3. On the control CT of the brain in postoperative period in one case the point subarachnoid hemorrhages was determined. In the other two cases there was no evidence hemorrhagic transformation. Operated patients showed positive dynamics: a decrease hemiparesis by 1 poin and regression of mental disorders. The patients were discharged withm RS 1‒2. During the follow-up examination 90 days the neurological condition of the patients improved to mRS 1‒0.Conclusions. Results obtained in increasing the “therapeutic window” for revascularization of the occluded ICA allow to continue research in the indicated direction and improve the quality of surgical care for patients with acute stroke.","PeriodicalId":325397,"journal":{"name":"Ukrainian Interventional Neuroradiology and Surgery","volume":"82 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127841497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Experience in treating patients with a combination of the descending aorta saccular aneurysm and spondylodiscitis","authors":"M. Tonchev, V.M. Muzhevska, О.M. Bezkorovainyy, V.M. Mitchenok, V. Kravchenko","doi":"10.26683/2786-4855-2021-1(35)-66-71","DOIUrl":"https://doi.org/10.26683/2786-4855-2021-1(35)-66-71","url":null,"abstract":"The article presents a clinical case of treatment of a patient with spondylodiscitis of two levels – thoracic and lumbar spine spondylodiscitis combined with the thoracic aorta aneurysm. A 68-year-old patient was hospitalized in the Neurosurgical Department of the M.V. Sklifosovsky Poltava Regional Clinical Hospital in August 2019 with complaints of pain and discomfort in the thoracic and lumbar spine, shoulder joints, severe weakness in the lower extremities. The multislice computed tomography with intravenous contrast revealed a sac-like aneurysm of the descending thoracic aorta at the level of vertebrae Th4-Th5 with invasion into the vertebral bodies, spondylodiscitis of vertebrae Th4-Th5 and Th11-Th12 with deformation of the spinal axis, the formation of absolute stenosis of the spinal canal at the level of vertebrae Th11-Th12. At the first stage of the surgery, the thoracic aortic arthroplasty was performed using TAA Stent Graft System (Ankura, China) 34 × 34 × 160 mm at the M.M. Amosov National Institute of Cardiovascular Surgery and the exclusion of the descending aorta aneurysm from the bloodstream was maintained. At the second stage, transpedicular stabilization of the spine at the level of vertebrae Th10-Th11-L2-L3 was performed at the M.V. Sklifosovsky Poltava Regional Clinical Hospital using Legacy system (Medtronic, USA) and spinal cord compression was eliminated. The treatment of spondylodiscitis at the level of the vertebrae Th4-Th5 was conservative with the use of osteotropic antibacterial drugs. The patient was mobilized in the early post-surgical period after stabilization of the spine. Regression of pain syndrome and lower paraparesis was noted. Further observation was performed on an outpatient basis. According to the modified Rankin Scale, which allows assessing the degree of independence of the patient in everyday life, the patient was evaluated with 3 points at discharge. A follow-up examination at 3, 12, and 24 months showed that the functioning of the stent-graft and transpedicular system were satisfactory. The result of 0 points according to the modified Rankin Scale.Patients with the thoracic spine spondylodiscitis require special attention and additional diagnostic procedures. The risk of additional combined pathology in the form of thoracic and abdominal aorta aneurysms should be considered when planning surgical treatment.","PeriodicalId":325397,"journal":{"name":"Ukrainian Interventional Neuroradiology and Surgery","volume":" 20","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132041604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}