Unique surgeries to install fenestrated stent grafts for complex abdominal aortic aneurysms performed for the first time in Tatarstan
Truly groundbreaking surgeries were performed at the University Clinic – for the first time in the history of the Republic of Tatarstan, surgeons installed customized fenestrated stent grafts in patients with one of the most complex forms of abdominal aortic aneurysm.
A team including Albert Alkhazurov, Head of the Department of X-ray Surgical Treatment and Diagnostics; Seyedin Khizriev, Head of the Cardiovascular Surgery Department; Lenar Mindubaev, Cardiovascular Surgeon; and Anna Gorshenina, Anesthesiologist and Resuscitator, successfully operated on three patients aged 62 to 74. A unique vascular prosthesis (stent graft) was developed and installed for each patient.
The surgeries were performed in collaboration with leading experts in this field from the Republican Cardiology Center (Ufa, Republic of Bashkortostan) – Timur Khafizov, Head of the Department of X-ray Surgical Diagnostic and Treatment Methods, and Ilyas Idrisov, an X-ray endovascular surgeon.
An abdominal aortic aneurysm is a dilation of the wall of the main, large blood vessel that supplies the body with blood. Most often, the condition remains asymptomatic for a long time, but carries a serious risk: rupture of the aneurysm. If this occurs, the chances of survival are extremely low – the mortality rate exceeds 90 percent. Particularly challenging are cases where the aneurysm affects the so-called visceral arteries, the blood vessels responsible for supplying vital organs such as the kidneys, liver, intestines, and pancreas.
Traditional surgical methods in such conditions are associated with enormous risks, requiring large incisions and a lengthy recovery period. That’s why the surgical team at the University Clinic used a cutting-edge technique: the installation of a fenestrated stent graft. This is a specialized vascular prosthesis with ‘windows’—holes where the internal organ vessels branch off from the aorta. A key feature of the procedure is that each window is individually designed for the patient’s anatomy based on CT angiography and 3D modeling.
“This high-tech surgical treatment consists of two stages. During the first, we performed a contrast-enhanced computed tomography (CT) scan of the aorta on each patient, and based on the results, we performed a 3D modeling of the aneurysm section requiring grafting. It was important to consider the location and level of the vessels in order to create the necessary windows for them. We sent this data to fabricate a custom-tailored stent graft for each patient. Once these were ready, we scheduled the second stage of the surgery for their installation,” said Albert Alkhazurov.
Stent graft placement is performed through mini-incisions in the arteries of the upper or lower extremities under X-ray guidance. This high-tech procedure requires modern X-ray equipment with extensive functionality, including additional auxiliary programs for 3D reconstruction of the aorta and its branches. During the procedure, the surgeon must perfectly align the “windows” in the stent graft with the arterial orifices and then install additional mini-grafts through these openings for each organ. This not only eliminates the risk of aneurysm rupture but also completely preserves the blood supply to all vital organs.
Early patient mobilization is another clear advantage. After surgery, patients can get up the very next day and begin recovery, which is unthinkable after major open procedures.
“Previously, only open surgery could help such patients, which carried a huge risk of complications. Therefore, doctors were often forced to refuse to perform them. This operation is not only a breakthrough in vascular surgery but also an example of personalized medicine, where the solution is tailored to each individual, and the success of the intervention largely determines the quality and length of life,” added Alkhazurov.
In 2025, within the allocated quotas, the University Clinic surgeons plan to perform two more similar high-tech interventions, bringing the total number to five. For our province, this success marks an important chapter in the development of high-tech medicine.