Sparing Treatment of Thoracic and Abdominal Aortic Aneurysms

Abstract

A comparison of results of sparing treatment obtained at 2, 4 and 6 years of follow-up in subjects with descending aortic atherosclerotic aneurysms (DAAs), and during the period between 1.5 and 8.9 years in subjects with dissecting thoracoabdominal aortic aneurysms (DTAAs) has been made. All subjects received conservative treatment to maintain optimal levels of BP, cholesterol and LDL cholesterol, as well as to reduce oxidative and inflammatory processes in aorta, strengthen aortic walls and stabilize the course of the disease. Rapid negative changes (diameter increased by more than 5 mm within a 6-month period) and the absence of contraindications for surgery prompted us to perform open or endovascular aortic repair. Available data suggest that both DAAs and TAAs are comorbidities, which at any time can abruptly terminate patient’s life, and operative treatment guarantees no safety from ruptures. When using sparing treatment of DAA, survival rates were 90.1% at 2 years, 76.8% at 4 years, and 59.4% at 6 years, with uniform survival increment mainly due to comorbidity. Survival rate seen in TAA group (81.8%) was more acceptable due to a younger age of patients.