Clinical, instrumental and laboratory characteristics of patients with aneurysm and aneurysmal expansion of the abdominal aorta

DOI: https://doi.org/10.25512/DIR.2020.14.1.02

For quoting:
Kabardieva M.R., Andreevskaya M.V., Lepilin P.M., Heymets G.I., Komlev A.E., Kolmakova T.E., Salichkin D.V., Kuchin I.V., Shariya M.A., Imaev T.E., Naumov V.G. "Clinical, instrumental and laboratory characteristics of patients with aneurysm and aneurysmal expansion of the abdominal aorta ". Journal Diagnostic & interventional radiology. 2020; 14(1); 18-26.

authors:

Kabardieva M.R.

Andreevskaya M.V.

Lepilin P.M.

Heymets G.I.

Komlev A.E.

Kolmakova T.E.

Salichkin D.V.

Kuchin I.V.

Shariya M.A.

Imaev T.E.

Naumov V.G.

keywords:

abdominal aortic aneurysm (AAA)

atherosclerosis

screening

multislice computed tomography (MSCT)

Abstract

Aim: was to study features of the clinical course, instrumental and biochemical parameters of patients with atherosclerotic aneurysmal expansion of the abdominal aorta on the base of retrospective analysis and prospective observation to determine indications for timely surgical correction.

Materials and methods: patients with the maximum diameter of the infra-renal abdominal aorta from 26 to 50mm (n=60) without primary indications for surgical treatment (endovascular abdominal aortic aneurysm repair) were selected for the prospective follow-up group. For the period of 2 years, all patients from prospective group underwent duplex scanning of the abdominal aorta every 6 months and multislice computed tomography (MSCT) of the aorta – once a year. The retrospective analysis included results of preoperative clinical-instrumental and laboratory examination of patients (n=55) who underwent endovascular aneurysm repair (EVAR) of the abdominal aorta with a maximum diameter of the infra-renal abdominal aorta more than 50mm.

Results: when comparing clinical, instrumental and biochemical parameters in patients with abdominal aortic aneurysm (AAA) before surgery and atherosclerotic aneurysmal abdominal aortic expansion of different degrees, not requiring surgical correction at the time of inclusion, it was shown that patients with AAA, statistically significantly differed from patients with AAA in clinical symptoms (pulsation and abdominal pain), burdened heredity, the number of smokers. There were no statistically significant differences in the severity of coronary and peripheral atherosclerosis. When comparing results of ultrasound duplex scanning and MSCT to estimate linear dimensions of the abdominal aorta in the group of patients with aneurysmal dilation and in the group of patients with abdominal aortic aneurysm, the comparability of results has been revealed. Prospective observation of patients with abdominal aortic aneurysmal dilation revealed predictors of disease progression: age less than 65 years, diameter of the upper third of the abdominal aorta more than 23mm, maximum diameter of the abdominal aorta more than 43mm, length of aneurismal dilation more than 52mm.

Conclusion: obtained results allowed to determine most informative indicators and criteria for the progression of atherosclerotic aneurysm expansion of the abdominal aorta, to determine further tactics of treatment, including the need for surgical correction of this pathology.

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