SCREENING DIAGNOSIS OF ABDOMINAL AORTIC ANEURYSMS.
THE TREATMENT POLICY FOR MINOR AORTIC ANEURYSMS

P.O. Kazanchyan, A.V. Boikov, V.A. Popov

On account of a considerable growth of the incidence of abdominal aortic aneurysms (AAA), unfavourable results of the surgical treatment of ruptured aneurysms, and an unpredictable disease course we have carried out a screening diagnosis for early pathology detection. Altogether 455 persons aged 50 to 89 years were examined. Preaneurysmal dilatation was present in 30 (6.6%) persons: in 4.98 (n=14) aged 50 to 64 years, in 8.5% (n=11) aged 65 to 79 years, and in 11.1% (n=5) aged 80 years and older. Minor aortic aneurysms (range 35-49 mm) were found in 2.2% (n=10): in 1.42% (n=4) aged 50 to 64 years, in 3.8% (n=3) aged 65 to 79 years, and in 6.6% (n=3) aged greater than 80 years. Aortic aneurysms greater than 50 mm were identified in 7 (1.53%) persons: in 0.4% (n=11) aged 50 to 64years, in 2.8% (n=4) aged 67 to 79 years, and in 4.8% (n=2) aged greater than 80 years. We have also developed indications for surgery in patients with minor aortic aneurysms based on computed tomography (CT)-revealed morphologic changes in the aneurysmal sac wall which enhance the risk of aneurysmal rupture, on the basis of factors increasing the risk of embologenic complications, lesion of the visceral branches of the abdominal aorta, and the presence ofocclusive lesions of the aortoiliac-femoral segments. We have analyzed the experience gained with the treatment of 40 patients presenting with minor AAA. Fourteen patients were operated on as soon as the diagnosis was confirmed. Twenty-six patients were followed up. They underwent control echoscanning and CT every 6 months. Ovei the follow up period the indications for surgical interventtoi were established in 12 more patients. One patient died myocardial infarction. At present 13 patients are still unc, observation. After operations for minor AAA there was с lethal outcome (the patient died of myocardial infarctiol).

KEY WORDS: screening diagnosis, abdominal ac aneurysms.

P. 96-110

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SCREENING DIAGNOSIS OF ABDOMINAL AORTIC ANEURYSMS.THE TREATMENT POLICY FOR MINOR AORTIC ANEURYSMS

SCREENING DIAGNOSIS OF ABDOMINAL AORTIC ANEURYSMS.
THE TREATMENT POLICY FOR MINOR AORTIC ANEURYSMS