Authors
Sleptsov P.A.1, Shlomin V.V.1, 2, Gusinskiy A.V.1, 2, Bondarenko P.B.1, 2, Kucherenko V.S.1, Fionik O.V.1, Panenkina V.V.1
1 Almazov National Medical Research Center, St. Petersburg
2 Municipal Multi-Specialty Hospital No. 2, St. Petersburg
Abstract
Purpose of the study: To compare the results of open surgical treatment of infrarenal aortic aneurysms with and without steno-occlusive lesions of the ilio-femoral segment.
Materials and methods: The analysis of the results of open surgical treatment of infrarenal aortic aneurysms was performed in 125 patients. The patients were divided into two groups: group 1 – aneurysm with occlusive-stenotic lesion of the ilio-femoral segment (n = 59), group 2 – aneurysm without hemodynamically significant lesion of the ilio-femoral segment (n = 66). All patients underwent resection of the abdominal aortic aneurysm with aorto-iliac or aorto-femoral bifurcation prosthetics.
Results: In-hospital mortality in group 1 was higher, 10% compared to 3% in group 2, but no statistically significant differences were found (p = 0.1). The main cause of mortality was the highest level of myocardial infarction (62%). The occurrence of cardiovascular complications was significantly more common in group 1 and amounted to 29% compared to 7% in group 2 (p = 0.002). The incidence of thrombosis of the prosthesis branches and lower limb arteries was 17% in group 1 compared to 4.5% in group 2 (p = 0.02). The time of clamping the aorta and lower limb arteries in group 1 was longer due to the need for arterial reconstruction (p = 0.03).
Conclusion:
1. Larger diameter (>70 mm) of abdominal aortic aneurysms (AAA) without hemodynamic lesion to the ilio-femoral segment (IFS) is associated with late diagnosis and associated with the asymptomatic nature of the disease and more often requires access via TFLT.
2. Smaller diameter (<50 mm) of AAA in patients with steno-occlusive lesion to the ILS is associated with early patient referral due to clinical presentation of chronic arterial insufficiency of the lower extremities.
3. Open surgical treatment of patients with AAA and occlusive-stenotic lesion to the ILS is accompanied by a high risk of cardiovascular complications and postoperative mortality compared to AAA without atherosclerotic lesion to the ILS.
Keywords: аbdominal aortic aneurysm, open surgical treatment, resection of abdominal aortic aneurysm, peripheral arterial disease.
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