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.
Highlights
The only reliable treatment modality used to treat descending aortic atherosclerotic aneurysms (DAAs) and TAA has been so far an operative intervention
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
Patients with thoracic and/or abdominal atherosclerotic aortic aneurysms were examined during a 2, 4- and 6-year period, and 33 subjects with dissecting AAs subjected to atherosclerosis with DeBakey type 1 and 3b who were treated in in- and outpatient settings over a period between 1.5 and 9 years (Table 1)
Summary
The only reliable treatment modality used to treat DAA and TAA has been so far an operative intervention. This is explained by a lack of investigations to study the etiopathogenesis of the disease and small experience in medical correction of those conditions. They showed that none of the existing methods is superior when it comes to DAA and TAA treatment. Multiple investigations suggest that at very early stages, they have much in common concerning mechanisms involved and serve as allies, whereas later each of them, having established its own way to enable the pathologic process, becomes a competitor [1] [2]
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