Journal «Angiology and Vascular Surgery» • 

2018 • VOLUME 24 • №3

State of the art of the problem concerning endovascular treatment of abdominal aortic aneurysms of infrarenal localization

Kuchin I.V., Imaev T.E., Lepilin P.M., Kolegaev A.S., Medvedeva I.S., Komlev A.E., Ternovoy S.K., Akchurin R.S.

Russian Cardiological Research and Production Complex of the RF Ministry of Public Health, Moscow, Russia

The problem concerning diagnosis and treatment of abdominal aortic aneurysms (AAA) is important today because of a high proportion of this pathology within the structure of population morbidity and mortality, with a tendency of these indices to increase, as well as high lethality rates in development of complications. Endovascular treatment of aortic aneurysms is one of the most rapidly developing methods of treatment in vascular surgery. Over the last two decades this type of treatment has been playing an important part in the armamentarium of the vascular surgeon and is often considered as primary treatment of patients with AAA of infrarenal localization. Nevertheless, long-term efficacy and reliability of this method have been argued. These argues are based on the fact that according to the findings of various studies the advantages of endovascular treatment of aneurysms over open surgical treatment are completely leveled after 6-8 years. The main disadvantage of endovascular treatment is the necessity of repeat interventions in the long-term period of follow-up. However, in a series of studies repeat interventions in groups of both surgical and endovascular treatment were either not taken into account or not specially studied. It should also be taken into consideration that first European studies were carried out with the use of grafts of first generations, and some of them are not used any more. Therefore, the necessity of carrying out further studies still remains. Perhaps, new generations will be able to decrease the frequency of repeat interventions and thereby improve the overall results of endovascular treatment. The possibilities of endovascular treatment of AAAs will constantly be extended, including due to the development of X-ray equipment and software, as well as at the expense of various auxiliary technologies.

KEY WORDS: abdominal aortic aneurysm, endovascular treatment of an aortic aneurysm, stent graft, EVAR.

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