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Ways to Correct Indications for Surgical Treatment of Atherosclerotic Descending Aortic Aneurysms

Received: 13 February 2017     Accepted: 10 March 2017     Published: 3 May 2017
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Abstract

Recent studies suggest that the development of atherosclerotic descending aortic aneurysms (DAA) is a complicated process, which occurs due to a polymorphic nature of aortic wall abnormalities. They overlap and contribute to a wide variety of clinical manifestations. The inflammatory process may be the main reason for a rapid growth and rupture of the aneurysm. It also involves a mechanism of complex adhesion comprising of acute-phase proteins to low-density lipoproteins (LDLPs) as atherosclerotic lesions. This process occurs in the presence of connective tissue disorders, aortic wall focal cystic medianecrosis, poor management of arterial hypertension, aging, and reduced compliance. Therefore, the surgical treatment modality to treat DAA becomes less appealing. Additionally, it is not feasible to make indications for surgery based solely on linear aneurysmal diameter. However, medical correction has no contraindications for use.

Published in Advances in Surgical Sciences (Volume 5, Issue 3)
DOI 10.11648/j.ass.20170503.11
Page(s) 31-35
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2017. Published by Science Publishing Group

Keywords

Atherosclerotic Descending Aortic Aneurysms, Surgical and Conservative Treatment, Indications for Surgery, Pathogenesis and Mortality Rate

References
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[2] Hallett J. W. Jr. Abdominal aortic aneurysm: natural history and treatment // Heart Dis. Stroke. - 1992. -Vol. 1. - Р. 303-308.
[3] Lower Extremities Artery and Abdominal Aortic Aneurysm Adult Patient Management National Guidelines (Russian Consensus Paper), М: Bakoulev Scientific Center for Cardiovascular Surgery of Russian Academy of Medical Sciences, pp. 2011. – 140.
[4] Bokeria L. A. (2010) Thoracic and Thoracoabdominal Aortic Aneurysm Surgery: Guidelines for Healthcare Professionals / L. A. Bokeria, V. S. Arakelyan - M.: Bakoulev Scientific Center for Cardiovascular Surgery of Russian Academy of Medical Sciences. 394.
[5] Boersmа E. (2005) Perioperative cardiovascular mortality in non-cardiac surgery: validation of the Lee cardiac risk index/E. Boersma, M. D. Kertai, O. Schouten et al. //Amer. J. Med. 118, 1134-1141.
[6] Rachael O Forsythe, David E Newby, Jennifer M J Robson. (2016), Monitoring the biological activity of abdominalaortic aneurysms Beyond Ultrasound. 6, 817-824.
[7] EVAR trial participants. (2005) Endovascular aneurysm repair versus open repair in patients with abdominal aortic aneurysm (EVAR trial 1): randomized controlled trial \\Ibid/-. 365. 2179–2186.
[8] 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 \\ Ibid. 365. 2187-2192.
[9] Krylov V. P., Mrochek A. G., Titov L. P., Gaiduk V. N., Reut L. I., Smaliakou A. L. Can We Change a Look at Atherosclerotic Aortic Aneurism Treatment? Health, 2014, р 1345-1351.
[10] Mankevich N. V., Mrochek А. G., Krylov V. P., Gayduk V. N., Reut L. I., Smoliakou А. L. Predictors of atherosclerotic descending aortic aneurysms and correction. ‘Kardiologiia v Belarusi’, No. 5 (42), 2015 - pp.63-73.
[11] Krylov V. P., Titov L. P., Gayduk V. N., Reut L. I., Smаliakou A. L., Mankevich N. V. Atherosclerotic descending aortic aneurysm. Pros and cons of surgery\ World Journal of Cardiovascular surgery, 2015, 5, 91-101.
[12] Luneva Е. B., Uspensky V. Е., Mitrophanov L. B. et al. Factors contributing to thoracic aortic aneurysm development. ‘Rossiiski kardiologichesky zhurnal’ 2013, 1 (99), pp. 19-22.
[13] Cozjnsen L., Braam R. L., Waalewijn R/ et al. What is new in dilatation of the ascending aorta? Review of current literature and practical advice for the cardiologist. Circulation, 2011; 123: 924-8.
[14] Lederle F. A., Wilson S. E., Johnson G. R. et al. Aneurysm detection and management Veterans Affairs cooperative study group. Immediate repair compared with surveillance of small abdominal aortic aneurysm\\ N. Engl. J. Med. 2002, 346. 1437–1444.
[15] Yuan S., Jing H. Cystic medial necrosis: pathological findings and clinical implications. Rev Bras Cir Cardiovasc. 2011; 26. 1:107-15.
[16] Libbi Peter, Bonow Р., Mann D. et al. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. Elsevier. 2010, Chapter 56:1464.
[17] Nicholls S. C, Gardner J. B, Meissner M. H, et al. Rupture in small abdominal aortic aneurysms. J Vasc Surg 1998; 28: 884–8.
[18] Naghavi M, Libby P, Falk E, et al. From vulnerable plaque to vulnerable patient’s call for new definitions and risk assessment strategies: Part II. Circulation 2003; 108: 1772–8.
[19] Thompson MM, Jones L, Nasim A, et al. Angiogenesis in abdominal aortic aneurysms. Eur J Vasc Endovasc Surg 1996; 11: 464–9.
[20] Vallabhaneni SR, Gilling-Smith GL, How TV, et al. Heterogeneity of tensile strength and matrix metalloproteinase activity in the wall of abdominal aortic aneurysms. J Endovasc Ther 2004; 11:494–502.
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  • APA Style

    Vladimir Petrovich Krylov, Nikolay Andreevich Manak, Valentina Nikolaevna Gayduk, Nadezhda Vladimirovna Mankevich, Leonid Ivanovich Reut. (2017). Ways to Correct Indications for Surgical Treatment of Atherosclerotic Descending Aortic Aneurysms. Advances in Surgical Sciences, 5(3), 31-35. https://doi.org/10.11648/j.ass.20170503.11

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    ACS Style

    Vladimir Petrovich Krylov; Nikolay Andreevich Manak; Valentina Nikolaevna Gayduk; Nadezhda Vladimirovna Mankevich; Leonid Ivanovich Reut. Ways to Correct Indications for Surgical Treatment of Atherosclerotic Descending Aortic Aneurysms. Adv. Surg. Sci. 2017, 5(3), 31-35. doi: 10.11648/j.ass.20170503.11

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    AMA Style

    Vladimir Petrovich Krylov, Nikolay Andreevich Manak, Valentina Nikolaevna Gayduk, Nadezhda Vladimirovna Mankevich, Leonid Ivanovich Reut. Ways to Correct Indications for Surgical Treatment of Atherosclerotic Descending Aortic Aneurysms. Adv Surg Sci. 2017;5(3):31-35. doi: 10.11648/j.ass.20170503.11

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  • @article{10.11648/j.ass.20170503.11,
      author = {Vladimir Petrovich Krylov and Nikolay Andreevich Manak and Valentina Nikolaevna Gayduk and Nadezhda Vladimirovna Mankevich and Leonid Ivanovich Reut},
      title = {Ways to Correct Indications for Surgical Treatment of Atherosclerotic Descending Aortic Aneurysms},
      journal = {Advances in Surgical Sciences},
      volume = {5},
      number = {3},
      pages = {31-35},
      doi = {10.11648/j.ass.20170503.11},
      url = {https://doi.org/10.11648/j.ass.20170503.11},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ass.20170503.11},
      abstract = {Recent studies suggest that the development of atherosclerotic descending aortic aneurysms (DAA) is a complicated process, which occurs due to a polymorphic nature of aortic wall abnormalities. They overlap and contribute to a wide variety of clinical manifestations. The inflammatory process may be the main reason for a rapid growth and rupture of the aneurysm. It also involves a mechanism of complex adhesion comprising of acute-phase proteins to low-density lipoproteins (LDLPs) as atherosclerotic lesions. This process occurs in the presence of connective tissue disorders, aortic wall focal cystic medianecrosis, poor management of arterial hypertension, aging, and reduced compliance. Therefore, the surgical treatment modality to treat DAA becomes less appealing. Additionally, it is not feasible to make indications for surgery based solely on linear aneurysmal diameter. However, medical correction has no contraindications for use.},
     year = {2017}
    }
    

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    T1  - Ways to Correct Indications for Surgical Treatment of Atherosclerotic Descending Aortic Aneurysms
    AU  - Vladimir Petrovich Krylov
    AU  - Nikolay Andreevich Manak
    AU  - Valentina Nikolaevna Gayduk
    AU  - Nadezhda Vladimirovna Mankevich
    AU  - Leonid Ivanovich Reut
    Y1  - 2017/05/03
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    N1  - https://doi.org/10.11648/j.ass.20170503.11
    DO  - 10.11648/j.ass.20170503.11
    T2  - Advances in Surgical Sciences
    JF  - Advances in Surgical Sciences
    JO  - Advances in Surgical Sciences
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    UR  - https://doi.org/10.11648/j.ass.20170503.11
    AB  - Recent studies suggest that the development of atherosclerotic descending aortic aneurysms (DAA) is a complicated process, which occurs due to a polymorphic nature of aortic wall abnormalities. They overlap and contribute to a wide variety of clinical manifestations. The inflammatory process may be the main reason for a rapid growth and rupture of the aneurysm. It also involves a mechanism of complex adhesion comprising of acute-phase proteins to low-density lipoproteins (LDLPs) as atherosclerotic lesions. This process occurs in the presence of connective tissue disorders, aortic wall focal cystic medianecrosis, poor management of arterial hypertension, aging, and reduced compliance. Therefore, the surgical treatment modality to treat DAA becomes less appealing. Additionally, it is not feasible to make indications for surgery based solely on linear aneurysmal diameter. However, medical correction has no contraindications for use.
    VL  - 5
    IS  - 3
    ER  - 

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Author Information
  • Vascular Surgery Laboratory, Republican Research and Practical Centre ‘Cardiology’, Minsk, Belarus

  • Heart Failure Laboratory, Republican Research and Practical Centre ‘Cardiology’, Minsk, Belarus

  • Vascular Surgery Laboratory, Republican Research and Practical Centre ‘Cardiology’, Minsk, Belarus

  • Outpatient Department of Republican Research and Practical Centre ‘Cardiology’, Minsk, Belarus

  • Vascular Surgery Laboratory, Republican Research and Practical Centre ‘Cardiology’, Minsk, Belarus

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