 صباح صاحيح كابون مواطن من العراق قد تأتي بعد مراجعة مستشفى من بيطار في العراق تبيرنا بأن هناك أعلامة بالصلب بعدها يبلغي من كل الديكاتر في العراق بين هناك خطورة على حياكي في خطورة العشريان الأبهر في هذه اللحظة ينفجر قد تأتي أعرف نفسي على أطبق مستشفى ماني باول بيطار بايت فيل دبتور بيبك وبعدني قاش عميب مع دبتور اللاجة أعود ثلاثة من العراق من العراق من باكدار that come to us كان هناك أصبحت أصبحت باكدار عندما أرى أنه أصبحت بايت فيل أصبحت 200 by 80 كان already investigated في باكدار where they told him that he has a problem called Iotic Disception من أعطاء هناك بايت فيل or a blood vessel called the Iota which supplies blood to the rest of the body في بعض الناس who have uncontrolled BP this Iota can get split the wall of the Iota can get torn so because of the constantly high blood pressure the wall gets torn in place of one pipeline now you have two pipelines and the second one is very weak so it can anytime get rupture it can also cause problems by giving poor blood supply to the brain poor blood supply to intestines it can be life threatening one of the main reason for the development of this Iota Disception is uncontrolled hypertension so before admission his blood pressure is always maintained at around 200 by 100 and like that so we discussed it with our cardiologist جنوار and we did another CT scan to see the extent of the disease and when we realized that this disease is life threatening we decided to take it up early search main thing is the pre-operative planning that is important rather than the procedure what here we did it we thoroughly studied his CT angiogram MR angiogram of the Iota and properly planned what kind of graft has to be taken what is the length of the graft what is the diameter before doing the procedure we optimized his medications and kept the blood pressure under control now the blood pressure is 110 over 80 and what we learned is that there are two procedures and after the surgery the first procedure was done and it continued 7 hours and a half and the second procedure it continued 3 hours and it took us 3 hours and it took us 3 hours after proper planning we took him out and which was perfectly done in two stages the first stage is a de-branching followed by the end of the surgery the pain the pain the pain the pain the pain the pain the pain the pain the pain the pain the pain the pain the pain the pain he responded very well now there is no pain for him there is no back pain he is able to walk he is able to do all his activities and this multidisciplinary approach is highly required for tackling this kind of complex cases which is not possible in other centers where routinely they do some kind of bypass operations and other things I would like to advise for all the patients to come to Mustafa Manipa hospital by-field and for those who loved me and for those who wanted to treat me and for those who wanted to treat me and for those who wanted to treat me and for those who wanted to treat me and for those who wanted to treat me and for those who wanted to treat me and for those who wanted to treat me and for those who wanted to treat me and for those who wanted to treat me and for those who wanted to treat me and for those who wanted to treat me and for those who wanted to treat me and for those who wanted to treat me and for those who wanted to treat me and for those who wanted to treat me and for those who wanted to treat me and for those who wanted to treat me