Anevrismul aortic abdominal, tratament, opţiuni şi rezultate

Abstract

Background: The Abdominal Aortic Aneurysm (AAA) represents 12 causes of mortality in elderly subjects in the USA. Small aneurysms are symptomless, clinical signs can manifest in a large diameter. The natural evolution of the AAA lead to the rupture, the death rate in an acute rupture varies between 62-94%. Nonetheless, the surgical risk of the procedure can be assumed in the exceeding 5.0-5.5 diameter AAA. Generally, 2 options of surgery can be regarded. Open and Endovascular Aneurysm Repair. This study is focused on the meta-analysis of the methods from different published studies, contrasting the aneurysm repair results in mid and long terms. Conclusions: The screening of the risk group reduces the mortality by AAA. The ultrasound monitoring is recommended for a diameter between 3.0 and 5.0 cm and an interventional treatment is indicated for the aneurysms larger than 5.0 cm in men and 4.5 cm in women. The perioperative mortality can be reduced by the introduction of the drug therapy in scheduled surgery of AAA and by controlled hypotension with limited volume perfusion in ruptured AAA. The death rate in scheduled endovascular treatment is under 2%, whereas in open version can arise up to 6-7%. The long follow-up shows similar results for both methods. According to the current studies, the application of endovascular technology has no benefit in long-term follow-up.