Health  Vol.10 No.4 , April 2018
Sparing Treatment of Thoracic and Abdominal Aortic Aneurysms
Abstract: A comparison of results of sparing treatment obtained at 2, 4 and 6 years of follow-up in subjects with descending aortic atherosclerotic aneurysms (DAAs), and during the period between 1.5 and 8.9 years in subjects with dissecting thoracoabdominal aortic aneurysms (DTAAs) has been made. All subjects received conservative treatment to maintain optimal levels of BP, cholesterol and LDL cholesterol, as well as to reduce oxidative and inflammatory processes in aorta, strengthen aortic walls and stabilize the course of the disease. Rapid negative changes (diameter increased by more than 5 mm within a 6-month period) and the absence of contraindications for surgery prompted us to perform open or endovascular aortic repair. Available data suggest that both DAAs and TAAs are comorbidities, which at any time can abruptly terminate patient’s life, and operative treatment guarantees no safety from ruptures. When using sparing treatment of DAA, survival rates were 90.1% at 2 years, 76.8% at 4 years, and 59.4% at 6 years, with uniform survival increment mainly due to comorbidity. Survival rate seen in TAA group (81.8%) was more acceptable due to a younger age of patients.
Cite this paper: Krylov, V. , Shevtsov, D. , Popel, G. , Zhigalkovich, A. , Gaiduk, V. , Reut, L. , Smolyakov, A. , Shestakova, L. and Mankevich, N. (2018) Sparing Treatment of Thoracic and Abdominal Aortic Aneurysms. Health, 10, 458-466. doi: 10.4236/health.2018.104037.

[1]   Nagornev, V.A. (1996) Cytokines, Immune Inflammation and Atherosclerosis. Uspekhi sovremennoy biologii, 2, 320-331. (In Russian)

[2]   Titov, V.N. (1999) Atherosclerosis and Inflammations: Specificity of Atherosclerosis as an Inflammatory Process. Russian Journal of Cardiology, 1999, 5. (In Russian)

[3]   Belov, Y.V. (2010) Our Failures and the Ways to Improve In-Hospital Mortality in Operative Treatment of Thoracoabdominal Aortic Aneurysms. Angiology and Vascular Surgery, 1, 105-112. (In Russian)

[4]   Bokeria, L.А. (2010) Surgery to Treat Thoracic and Thoracoabdominal Aortic Segments: Doctor’s Manual. A.N. Bakoulev Scientific Center for Cardiovascular Surgery, Moscow, 394.

[5]   EVAR Trial Participants (2005) Endovascular Aneurysm Repair versus Open Repair in Patients with Abdominal Aortic Aneurysm (EVAR Trial 1): Randomized Controlled Trial. Lancet, 365, 2179-2186.

[6]   EVAR Trial Participants (2005) Endovascular Aneurysm Repair and Outcome in Patients Unfit for Open Repair of Abdominal Aortic Aneurysm (EVAR Trial 2): Randomized Controlled Trial. Lancet, 365, 2187-2192.

[7]   EVAR Trial Participants (2004) Comparison of Endovascular Aneurysm Repair with Open Repair in Patients with Abdominal Aortic Aneurysm (EVAR Trial 1), 30-day Operative Mortality Results: Randomized Controlled Trial. Lancet, 364, 843-848.

[8]   Gayduk, V.N., et al. (2014) Optimization of Management of Patients with Chronic Atherosclerotic Descending Aortic Aneurysm. Meditsina, 3, 20-26.

[9]   Mankevich, N.V., et al. (2015) Predictors of Progression of Atherosclerotic Descending Aortic Aneurysms and the Correction. Kardiologiya v Belarusi, 5, 63-73.

[10]   Barbukhatti, K.O. (2014) Kuban Registry of Type A Acute Aortic Dissections (KUBRADA). Kardiologiya I serdechnososudistaya khirurgiia, 6, 38-41.

[11]   Abugov, S.A., et al. (2013). Stenting of Thoracic Aortic Aneurysms in for De Bakey Type III Aortic Dissection. Khirurgiia, 2013, 67-72

[12]   Pape, L.A., et al. (2015) Presentation, Diagnosis, and Outcomes of Acute Aortic Dissection. 17-Year Trends from the International Registry of Acute Aortic Dissection. Journal of the American College of Cardiology, 66, 350-358.

[13]   Krylov, V.P., et al. (2014) Can We Change a Look at Atherosclerotic Aortic Aneurism Treatment? Health, 6, 1345-1351.

[14]   Nikonenko, А.А. (2013) The Role of Cyclophiline A in Pathogenesis of Abdominal Aortic Aneurysm. Kardiologiya I serdechnososudistaya khirurgiia, 6, 39-42.

[15]   Plavinsky, S.L. (2005) Planning, Processing and Presentation of Data Obtained from Biomedical Trials Using SAS System, Biostatistica. SPb MAPO, 559

[16]   Trisvetova, E.L. (2015) Diagnosis and Treatment of Congenital and Multifactorial Disorders of Connective Tissues. National Clinical Guidelines. Minsk.

[17]   Mikhaylov, D.V., et al. (2012) Perspectives of Preventive Treatment of Aneurysms of Major Vessels. Kardiologiya I serdechnososudistaya khirurgiia, 4, 51-56.

[18]   Vammen, S., et al. (2001) Randomized Double Blind Controlled Trial of Roxithromycin for Prevention of Abdominal Aortic Aneurysm Expansion. British Journal of Surgery, 88, 1066-1072.

[19]   King, V.L., et al. (2006) Selective Cyclooxygenase-2 Inhibition with Celecoxibdescreases Angiotensin 11 Induced Abdominal Aortic Aneurysm Formation in Mice. Arteriosclerosis, Thrombosis, and Vascular Biology, 26, 1137-1143.

[20]   Yuzefovich, N.А., et al. (2007) Morphometric Study to Assess Structural Components of Aortic Tunica Media Normal and Aneurysm-Surrounding Area. Meditsina, 4, 36-41.