“Disaster Medicine” Journal

DISASTER MEDICINE No. 1•2020

Original article

Ways to Improve Results of Treatment of Abdominal Aortic Aneurism Rupture

Pinchuk O.V., Obraztsov A.V., Yamenskov V.V.

The 3rd Central Military Clinical Hospital named after A.A.Vishnevsky, the Ministry of Defense of the Russian Federation, Moscow, Russian Federation

UDK 616-089

Pp. 38-42

Abstract. It is noted that the rupture of an abdominal aortic aneurysm is a serious complication, accompanied by a high level of mortality and postoperative complications. The data of scientific publications and own clinical experience of surgical treatment of the rupture are analyzed. The results of 20 surgical interventions performed for this pathology are summarized. Due to the use of modern technologies and improvement of surgical techniques, we managed to reduce the postoperative mortality rate from 63.6 to 55.0%.

Conclusions. Improvement of the results of treatment of the ruptures is possible under the following conditions: well-established integration of treatment and diagnostic units; reduction of the time interval between diagnosis and surgery; reduction of the volume of surgical trauma and the duration of performing anesthetic benefits; availability of blood services for reinfusion and necessary donor compensation; adequate medication in the intensive care unit and the possibility of extracorporeal detoxification.

Key words: abdominal aortic aneurysm rupture, abdominal aortic aneurysm, extracorporeal detoxification, occlusive balloon, reinfusion

For citation: Pinchuk O.V., Obraztsov A.V., Yamenskov V.V. Ways to Improve Results of Treatment of Abdominal Aortic Aneurism Rupture. Meditsina katastrof = Disaster Medicine. 2020; 1: 38-42 (In Russ.).

https://doi.org/10.33266/2070-1004-2020-1-38-42

REFERENCES

1. Kuchin I.V., Imaev T.E., Lepilin P.M., Kolegaev A.S., Medvedeva I.S., Komlev A.E., Ternovoy S.K., Akchurin R.S. The Current State of the Problem of Endovascular Treatment of Abdominal Aortic Anortic Localization. Angiologiya i sosudistaya khirurgiya. 2018; 24; 3: 60-65 (In Russ.).

2. Salata K., Syed M., Hussain M.A., de Mestral C., Greco E., Mamdani M., Tu J.V., Forbes T.L., Bhatt D.L., Verma S., Al-Omran M. Statins Reduce Abdominal Aortic Aneurysm Growth, Rupture, and Perioperative Mortality: a Systematic Review and Meta-Analysis. J. Am. Heart Assoc. 2018; 19; 7: 33 p.

3. Golledge J. Abdominal aortic aneurysm: update on pathogenesis and medical treatments. Nat. Rev. Cardiol. 2018. [Epub ahead of print] doi: 10.1038/s41569-018-0114-9.

4. Khryshchanovich V.Ya., Tret’yak S.I., Klimchuk I.P., Avdievich A.D., Romanovich A.V., Shagisultanov E.R., Popel’ G.A., Bol’shov A.V., Gerasimovich G.V. Rupture of Abdominal Aortic Aneurysm: Predictive Factors of Mortality. Novosti khirurgii. 2013; 21; 4: 51-56 (In Russ.).

5. Wang L.J., Prabhakar A.M., Kwolek C.J. Current Status of the Treatment of Infrarenal Abdominal Aortic Aneurysms. Cardiovasc. Diagn. Ther. 2018; 1; 8: 191-199.

6. Zatevakhin I.I. Complicated Abdominal Aortic Aneurysms. Aktual’nye voprosy sosudistoy khirurgii = Actual Vascular Surgery Issues. Materials of X International Conference on Vascular Surgery. 2011, pp. 15-21 (In Russ.).

7. Aurelian S.V., Adrian M., Andercou O., Bruno S., Alexandru O., Catalin T., Dan B. Neutrophil-to-lymphocyte Ratio (NLR): a Comparative Study of Rupture to Non-Ruptured Infra-Renal Abdominal Aortic Aneurysm. Ann. Vasc. Surg. 2019. [Epub ahead of print] doi: 10.1016/j.avsg.2018.11.026.

8. Sidloff D.A., Saratzis A., Sweeting M.J., Michaels J., Powell J.T., Thompson S.G. Sex Differences in Mortality after Abdominal Aortic Aneurysm Repair in the UK. Br. J. Surg. 2017; 104: 1654-1666.

9. Oliveira-Pinto J., Sousa J., Mansilha A. Tratamento do Аneurisma da Аorta Аbdominal Roto: Estado da arte. Acta Med. Port. 2018; 31; 4: 213-218.

10. Shklovskiy B.L., Karandin V.I., Vinogradov S.N., Baksheev V.I. Atherosclerosis: in Search of Truth. Gospital’naya meditsina: nauka i praktika. 2018; 1; 1: 42-46 (In Russ.).

11. Soares F.R., Gomes O.N., Oliveira-Pinto J., van Rijn M.J., Ten R.S., Verhagen H.J., Bastos G.F. Review on Management and Outcomes of Ruptured Abdominal Aortic Aneurysm in Women. J. Cardiovasc. Surg. 2018; 59; 2: 195-200.

12. Sakalihasan N., Michel J.B., Katsargyris A., Kuivaniemi H., Defraigne J.O., Nchimi A., Powell J.T., Yoshimura K., Hultgren R. Abdominal Aortic Aneurysms. Nat. Rev. Dis. Primers. 2018; 4; 1: 1-22.

13. Lucas C., Costa J., Paixão J., Silva F., Ribeiro P., Rodrigues A. Low Back Pain: A Pain That May Not Be Harmless. Eur. J. Case Rep. Intern. Med. 2018; 5; 3. 000834.

14. Kazanchyan P.O., Popov V.A., Sotnikov P.G. Ruptures of Abdominal Aortic Aneurysm. Features of Clinical Course and Classification. Angiologiya i sosudistaya khirurgiya. 2003; 9; 1: 84 (In Russ.).

15. Lemenev V.L., Mihaylov I.P., Shcherbyuk A.A. Experience of Surgical Treatment of Patients with Abdominal Aortic Aneurysm Ruptures. Angiologiya i sosudistaya khirurgiya. 2001; 7; 4: 96-102. (In Russ.).

16. Choong A.M.L., Maryot J., Wee I.J., Syn N., Maryot T., Brightwell R.E., Walker P.J. Forecasting Aortic Aneurysm Rupture: a Systematic Review of Seasonal and Atmospheric Associations. J. Vasc. Surg. 2019. [Epub ahead of print] doi: 10.1016/j.jvs.2018.09.030.

17. De Bekey M.E., Kuli D.A., Krouford E.S., Morris D.S. Khirurgiya aorty i krupnykh perifericheskikh arteriy = Surgery of the Aorta and Large Peripheral Arteries. Moscow, Medgiz Publ., 1960, 88 p. (In Russ.).

The material was received 23.10.19; the article after peer review procedure 26.12.19; the Editorial Board accepted the article for publication 11.03.20