Treatment of abdominal aortic aneurysm. Abdominal aortic aneurysm: symptoms, diagnosis, treatment. Treatment of peritoneal aortic aneurysm

Aortic aneurysm abdominal cavity is a pathological expansion of the walls of this arterial vessel, which can lead to its rupture as a result of thinning. Danger vascular disease is the likelihood of asymptomatic progression and death as a result of abdominal aortic dissection and subsequent bleeding.

Causes

An aneurysm is a protrusion of the walls of a vessel and its acquisition of the shape of a sac. The formation of an abdominal aortic aneurysm and the reasons that caused it are due to the influence of various factors. The main ones are:

atherosclerosis;
defect on local area vascular wall;
blood pressure surges;
inflammatory processes in the aorta.

When the wall of the vessel is thinned and weakened, rupture of the abdominal aorta is possible, the causes of which are also due to the above factors.

Symptoms

Approximately ¼ of all patients diagnosed with an abdominal aortic aneurysm do not experience any symptoms of the disease. Not only are there no complaints, but examination does not always reveal signs of pathology. This course is the most dangerous, since it is not possible to control the likelihood of aneurysm rupture.

There are often cases when rupture of the aortic artery is the first manifestation of the disease. This situation is fraught with rapid death. But in most cases, the pathology can be recognized before such a complication occurs. The asymptomatic type of the disease is more often detected on ultrasound or during abdominal surgery for other pathologies.

The characteristic symptoms of an abdominal aortic aneurysm are as follows:

Pain in the groin and abdomen varying degrees severity, in most cases dull and aching. Most often localized in the mesogastrium and epigastrium. Appears after eating or physical activity. It intensifies with movement and radiates to the lower back or sacrum.
Pulsation in the abdomen. It can be intense and resemble a contraction of the heart muscle. This feeling is constantly present or renews after physical work.
Dyspeptic phenomena. Nausea, vomiting, bloating act as secondary signs, which manifest themselves as a result of compression of the abdominal organs.

All signs of aortic aneurysm, according to the nature of the manifestations, are combined into groups: abdominal, ischioradicular, urological.

When the aneurysm reaches big size, the blood supply to the gastrointestinal tract deteriorates, the stomach and duodenum are compressed, which manifests itself in indigestion and symptoms such as nausea, heartburn and belching, stool instability and rapid weight loss.

Ischioradicular symptoms are caused by compression of the nerve roots of the lumbar spine. These include:

impaired sensitivity of the skin on the legs;
numb feeling lower limbs;
intermittent claudication;
lower back pain.

Manifestations of a urological nature are provoked by compression of the ureter and displacement of the kidneys from the anatomically correct position. The patient complains of heaviness in the lumbar region and difficulty urinating. There may be blood in the urine. The possibility of developing renal colic cannot be excluded.

Diagnostics

A set of examinations aimed at identifying an aortic aneurysm includes general examination and instrumental diagnostic methods. Pathology can be suspected by palpation and auscultation of the abdominal area. Thus, signs of a disorder are: increased pulsation, felt through the anterior abdominal wall, and systolic murmur.

The most accessible instrumental method for diagnosing the pathology in question is plain radiography. Using it, you can visualize the shadow of an aneurysm and detect pathological expansion due to calcification of the walls of this artery.

To the number modern methods refers to ultrasound with duplex scanning of the main artery and branches of the aorta. Ultrasound examination makes it possible to identify a defect in the vascular wall with maximum accuracy. In particular, the following parameters are determined:

the prevalence of the aneurysm and its location;
condition of the walls of the main artery;
presence and location of rupture.

It is possible to determine a rupture of an abdominal aortic aneurysm or a threatening condition using computed multislice tomography of the abdominal aorta.

Treatment

Considering that aortic rupture can occur suddenly, when it is first detected, a decision is made to remove the damaged area. Enlargement of the abdominal aorta is treated only with surgical methods.

Medication

Drug treatment for abdominal aortic aneurysm is aimed only at strengthening the walls of the artery to prevent its rupture. If there is a weak spot in the vessel, the aneurysm cannot disappear on its own. It will gradually stretch under the influence high pressure in the aorta. This defect can only be corrected surgically.

No medicine can reduce this pressure because it is physiologically designed and necessary for pumping blood in the body. Drug treatment is used for preventive purposes to eliminate diseases that can weaken the walls of the aorta. In addition, for the purpose of prevention, medications are taken:

to normalize blood pressure;
to reduce blood cholesterol;
to eliminate the severity of autoimmune processes;
to control bleeding disorders;
for the treatment of chronic pathologies that are a contraindication to surgical correction aneurysms.

Surgical

Surgical treatment will allow you to completely get rid of the aneurysm by removing the defective section of the vessel. Therefore, it is impossible to do without surgery. It is performed through abdominal surgery or using endovascular surgery.

If it is possible to identify an enlargement of the aorta in the abdominal region, then the operation is carried out as planned and the patient is first prepared for the intervention. If a rupture occurs or a dissecting aneurysm is to be removed, then medical manipulation is carried out on an emergency basis.

During abdominal surgery, the abdominal wall is incised and direct access to the damaged area is provided. The deformed part is cut, and a special tube is inserted into the cavity, which will subsequently prevent rupture.

An aneurysm of any size and shape can be removed using this method.

The use of endovascular surgery allows the operation to be performed without dissection abdominal wall. Manipulations are carried out through the femoral artery. This method has a number of advantages over the cavity method: there is no risk of suture dehiscence and infection, a short rehabilitation period, and the blood flow in the aorta does not stop. But it is carried out only as planned, for emergency cases not suitable because it requires careful preparation of the patient.

Forecasts

Being a serious pathology, aortic aneurysm in the absence of timely medical care leads to death. This occurs as a result of rupture and massive bleeding. Since it is impossible to predict this vascular pathology, an unfavorable outcome occurs in 80% of cases.

The course of the disease and outcome are influenced by the following factors:

shape and size of the aneurysm;
reasons for education;
patient's age;
the presence of chronic pathologies;
compliance with doctor's recommendations.

Because aneurysm is difficult to predict, people with a predisposition to the condition and a tendency to form blood clots are advised to undergo regular screening to reduce the risk of rupture. It is important to give up bad habits.

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Abdominal aortic aneurysm is a fatal disease for humans. The problem of the pathology lies in its asymptomatic course at an early stage of development. The disease develops slowly. The aneurysm grows and expands in size over the years. The aortic tissue in this area becomes thinner, and a rupture occurs at the thinnest point of the pathology. Cure the disease medications on this moment impossible; to eliminate it, use surgical intervention.

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Description of the disease

An abdominal aortic aneurysm is a diffuse dilation of the walls of the aorta in its abdominal cavity. Protrusion of the vessel wall occurs at a height of 8-6 lumbar vertebra. In cardiological practice, abdominal aortic aneurysm occurs in 95% of all cases of aneurysmal diseases.

The disease occurs more frequently in older people, especially men over 60 years of age. The disease is diagnosed in 2.5% of elderly patients who seek medical help. Pathology tends to develop over a long period of time. The aneurysm increases in size by 10% per year. After 8 years of the disease, a rupture occurs.

Classification of abdominal aortic aneurysm:

Gradual development of aneurysm

The pathology is considered small if its size does not exceed 3-5 cm. The average is 5-7 cm, and the large one is over 7. A person is registered when a small aneurysm is detected. You should be examined every 6 months.

Causes

More than 80-90% of cases of abdominal aortic aneurysm development are due to atherosclerosis. This is a disease in which, due to the deposition of cholesterol, calcium and fibrous tissue A blood clot forms in the vessels.

Other reasons for the development of abdominal aortic aneurysm:

inflammatory processes associated with diseases such as syphilis vascular lesions, tuberculosis, salmonellosis, mycoplasmosis, rheumatism and nonspecific aortoarteritis;
fibromuscular dysplasia causes the formation of a congenital aneurysm;
technical errors during aortic dilatation, reconstructive surgery, angiography or prosthetics;
smoking contributes to the development of vascular pathologies;
age over 60 years;
chronic blood pressure 140/80;
excess weight and lack of physical activity.

The likelihood of developing pathology increases in people suffering from arterial hypertension and chronic lung diseases. Big influence influences the shape and size of the aneurysm. Asymmetric aneurysms are known to be more prone to rupture. If the pathology exceeds 9 cm, then the chance of vessel rupture is more than 75% within a year.

Symptoms

Symptoms are usually absent in uncomplicated disease. Pathology is discovered accidentally during palpation of the abdomen, ultrasound, abdominal x-ray or laparoscopy. Symptoms appear after the aneurysm enlarges to 3-5 cm:

Pulsation of the abdominal aorta is the first sign indicating the development of pathology. Over time, periodic It's a dull pain in the left half of the abdomen or mesogastrium. Painful sensations are associated with the pressure of growing pathology on nerve endings in the retroperitoneal space. The pain often radiates to the lower back or groin area.
Heaviness and feeling of fullness in the abdomen. A similar symptom appears due to mechanical compression of the abdominal aortic aneurysm by the stomach and duodenum. Nausea, constipation, flatulence, belching and vomiting appear.
Urological syndrome. Caused by increased compression in the ureter and displacement of the kidney. Hematuria with dysuric disorders appears. When the veins of the testicles are compressed, a nagging pain is observed in groin area in men.
Pressure on the roots of the spinal cord and vertebrae leads to a feeling of pain in the lower back and lower extremities.
Lameness in the left or right leg due to chronic ischemia vessels of the lower extremities.

Aneurysm rupture

Rupture of an abdominal aortic aneurysm is rapidly fatal. The situation is accompanied by a clinic of acute abdomen. The first signs of aortic rupture:

sharp abdominal pain in the lumbar region;
increased pulsation in the peritoneum;
collapse, drop in blood pressure;
loss of consciousness;
pale skin;
bloating.

The clinical picture will differ depending on the location of the rupture:

Retroperitoneal rupture. Observed pain syndrome of a permanent nature. If the hematoma extends to the pelvic area, the pain radiates to the thigh. When a high-lying hematoma forms, the pain will be similar to cardiac pain. Typically, with a retroperitoneal rupture of an aneurysm, the amount of blood flowing out does not exceed 200 ml.
Intra-abdominal localization of the rupture. The clinic of massive hemoperitoneum is developing. Symptoms increase rapidly. They turn pale skin, appears cold sweat, weakness, the pulse becomes thread-like and frequent, hypotension develops. The abdomen will be swollen and painful in all parts. Percussion reveals the presence excess liquid in a stomach. With this localization of the rupture, death occurs very quickly.
Into the inferior vena cava. Shortness of breath, tachycardia, swelling of the lower extremities, pain in the abdomen and lower back appear. Listening to the abdominal region reveals a systole-diastolic murmur. Symptoms increase gradually and ultimately lead to heart failure.
Gap in duodenum. Observed gastrointestinal bleeding. First, the patient will vomit blood, and then collapse occurs.

If an aneurysm ruptures, emergency surgery is prescribed. The chances of saving a person increase if this happened in a hospital setting. However, even after surgery, it is possible to save a person only in 10% of all cases; the remaining 90% of patients die from internal bleeding.

Diagnostics

Diagnosing an aneurysm is quite difficult. Its symptoms are either absent or similar to diseases of the abdominal cavity or heart. You should consult a physician if you suspect an aneurysm. The doctor collects an anamnesis, where the patient indicates health complaints. After this, a primary picture of the disease is compiled, which requires confirmation. To achieve this, a number of studies are being carried out to differentiate abdominal aortic aneurysm from other diseases.

Diagnosis consists of the following studies:

examination of the patient;
X-ray examination;
ultrasound examination of the abdominal aorta;
Magnetic resonance imaging;
electrocardiography;
lab tests.

Physical examination

The purpose of this inspection is to collect information about physical condition body. Visible violations of health standards are identified.

Physical examination includes following methods research:

Visual inspection. This technique provides minimal information about aneurysm. Increase in pathology to medium and large sizes You can observe a pulsation that is transmitted to the abdominal wall. Purple spots appear on the abdomen when an aneurysm ruptures.
Percussion. Allows you to determine the approximate size of the pathology and its location. Dullness of percussion sound is heard.
Palpation. With an aneurysm of the abdominal aorta, a neoplasm pulsating in time with the heart is palpated. Differences between left and right heart rates right hand indicate the presence of an aortic arch aneurysm. A weakened or absent pulse in the femoral artery indicates an infrarenal aneurysm.
Auscultation. The technique is carried out using a stethoscope. By applying the device to the site of the aneurysm, you can hear the sound of blood flow.
Pressure measurement. An increase in pressure is detected.

A physical examination is performed by your doctor during your appointment. This diagnostic method is not a reason for making a diagnosis. It only allows you to assess the patient’s condition and draw preliminary conclusions. To confirm the diagnosis, it is necessary to undergo a series of studies aimed at assessing the immediate condition of the abdominal aorta.

X-ray

X-ray examination allows you to get a clear picture of the condition of the abdominal organs. Used to identify an aneurysm contrast agent, which is injected directly into the aorta.

In this way, it becomes possible to determine not only the location of the aneurysm, but also its size. X-ray examination is sufficient informative method, but MRI diagnostics should be used whenever possible.

Ultrasonography

Ultrasound of an abdominal aortic aneurysm is one of the highly informative methods that allows you to determine the location, size and condition of the pathology.

The condition of the vessels is assessed in real time. Ultrasound is a more common diagnostic method than x-ray examination. This is due to the high speed and painlessness of the procedure. Ultrasound allows you to examine the aorta for complications after surgery.

Magnetic resonance imaging

Exactly this informative research, which allows you to obtain information about the size of the aneurysm, its location, and find out the thickness of the vessels in the area of pathology. Nuclear magnetic resonance is used to perform MRI. The patient is placed in special equipment that creates an electromagnetic field. Therefore, there are a number of contraindications for diagnostics:

electronic implants;
hearing aid;
presence of pacemakers;
heart valve prostheses.

Magnetic resonance imaging for abdominal aortic aneurysm is an expensive diagnostic method. This requires special equipment, which is not available in all clinics and hospitals. Nevertheless, the study results are highly accurate. Therefore, it is highly recommended to undergo an MRI before surgery.

Electrocardiogram

An electrocardiogram for an abdominal aortic aneurysm is necessary to assess the performance of the heart. The study differentiates an aneurysm from anginal diseases, which have similar symptoms.

It allows you to identify the following deviations:

damage to the coronary vessels;
ischemic abnormalities are detected;
changes in the functioning of the heart.

Failures in cardiogram readings usually occur with pathologies of the aorta of the heart. An electrocardiogram allows you to eliminate suspicions of the development of a cardiac aneurysm.

Laboratory analysis

A blood or urine test alone will not show serious abnormalities. Diagnostics are prescribed to identify the causes that led to the formation of an aneurysm.

A laboratory blood test for an abdominal aortic aneurysm shows the following changes:

Increased level of leukocytes. Occurs when available infectious processes in organism.
Increased platelet count. Blood clotting increases.
Increased cholesterol. A deviation from the norm is considered to be an increase in its level to 5 mmol/l or higher.

Treatment

Medicines cannot cure an abdominal aortic aneurysm. Medicines are used to treat symptoms, but not the cause of the disease.

The following groups of drugs are prescribed:

cardiotropic.
anticoagulants and antiplatelet agents;
lipid-lowering;
antibiotics and antifungals;
correctors of glucose and blood sugar.

Treatment of abdominal aortic aneurysmcarried out surgical method . Whether elective or emergency surgery is used. The indication for surgery is an increase in pathology up to 5 cm.

The operation to remove an abdominal aortic aneurysm is performed as follows:

1. The patient is given anesthesia and put into artificial sleep.
2. Connect to a heart-lung machine.
3. The surgeon makes an incision in the abdominal cavity and exposes the aorta.
4. Clamps are applied to the vessel above and below the aneurysm.
5. The pathology is cut off, and the remaining sections of the vessel are sutured.
6. If necessary, an artificial prosthesis is installed, which is a synthetic tube capable of merging with human vascular tissue.

One operation takes from 2 to 4 hours. After this, the patient is transferred to the intensive care unit for observation for the next 7 days. The patient is discharged after 3 weeks if no complications occur after surgery.

Contraindications for surgery:

heart attack;
stroke;
chronic heart or kidney failure;
severe renal impairment;
acute infectious diseases;
diabetes;
acute inflammation in the abdominal cavity.

There are no contraindications to emergency surgery, since the benefits of it outweigh any possible risks.

Complications

With absence timely treatment There is a risk of developing the following complications:

Blood clot detachment. It is formed in the cavity of the aneurysm itself and is a mass of sticky platelets. On early stages its formation, it will not interfere with blood flow. There is a possibility of thrombus migration, which leads to blockage of thinner vessels. This could be an artery in the brain or capillaries in the heart. It is impossible to predict thrombus migration. Disruptions in blood circulation due to a blood clot lead to disturbances in tissue trophism and their subsequent death.
Clamping of the bile ducts. Occurs with an aneurysm of the abdominal aorta in the upper sections. The bile ducts that lead from the gallbladder to the duodenum are compressed. The outflow of bile and blood circulation are disrupted. The risk of developing cholecystitis and pancreatitis increases.

Complications after surgery:

pulmonary and cerebral edema;
renal failure;
violation of blood clotting in internal organs;
blood clot rupture.

Mortality after surgery is 34%.

Prevention

Before surgery, doctors monitor the progression of the pathology. If the growth of the abdominal aortic aneurysm is more than 0.5 cm over six months, then surgery will be prescribed. Before surgery, it is recommended to follow the following preventive rules:

Stick to healthy eating. Avoid fatty, fried, spicy and salty foods. Limit the consumption of animal fats. Create a menu of vegetables, grains, fruits, dairy products, fish and lean meat birds. Divide meals into 4-6 times a day. Food is best consumed boiled.
Monitor blood pressure. Reduce psycho-emotional stress and stress. Take medications that lower blood pressure.
Give up alcohol and cigarettes.
Limit physical exercise.
Correct symptoms of diseases such as diabetes, liver, kidney and heart diseases.

Abdominal aortic aneurysm: signs, diagnosis, treatment

The concept of “aneurysm” implies such a change in the structure of the vascular wall, when in itself weak point it becomes thinner and bulges out. This creates a risk of vessel rupture. One of the most dangerous localizations of such pathology is an abdominal aortic aneurysm.

Causes of aneurysm and damaging factors

It is important to understand why this disease occurs, because the number of deaths is catastrophically high: 50-60% of patients die 1-2 years after the discovery of an abdominal aortic aneurysm. Moreover, this pathology affects men an order of magnitude more often than women. The causes of deformation of the vascular wall are usually divided into inflammatory and non-inflammatory.

Video: the occurrence of an aortic aneurysm

Classification according to various criteria

Based on the structure and characteristics of tissue damage, aneurysms are divided into the following types:

True aneurysm, which is characterized by expansion of the lumen of the artery while maintaining the integrity of its wall;
False aneurysm is an expansion of the aortic lumen, in which the wall structure is damaged and blood can enter the tissue lining the vessel; as a result, a so-called “pulsating” hematoma is formed;
Dissecting aortic aneurysm, which is localized in the abdominal region; with such damage to the vessel, in addition to the expansion of the lumen, a cavity is observed in the thickness of the vascular wall, which communicates with the aortic lumen.

Based on their shape, they distinguish between fusiform and saccular aneurysms, and according to their clinical course - complicated and uncomplicated.

For more precise setting To make a diagnosis, doctors determine the nature and extent of the lesion, the length of the affected area of the artery; see if they are included in pathological process branches of vessels extending from the aorta. All these factors determine both the severity of the current situation and the choice of treatment tactics.

Symptoms and clinical manifestations of abdominal aortic aneurysm

The symptom that indicates an abdominal aortic aneurysm and with which patients most often turn to doctors is abdominal pain, which is dull and aching in nature. This pain may be constant or may occur periodically without visible reasons. It is usually localized in the left half of the abdomen or in the navel area. In some cases, the pain may radiate to the groin or lower back. Cause pain– an increase in the size of the affected area of the vessel, when the bulging wall of the aorta begins to put pressure on the roots of the spinal cord.

In some patients, an aneurysm may manifest as heaviness, distension in the abdomen, and a pulsating sensation. Sometimes, when the intestines are compressed, they appear dyspeptic symptoms(belching, nausea, vomiting).

Much more serious condition occurs when the course is complicated, and even more so when an aortic aneurysm ruptures. More pronounced signs are observed, characterized by an increase in the intensity of pain, which, moreover, is not relieved by painkillers. Gradually, the pain becomes girdling, blood pressure drops (sometimes catastrophically), and vomiting occurs. Also observed. A disturbance in the blood supply to the legs may develop.

The symptoms by which dissecting aortic aneurysm is determined usually occur in two stages:

In the first, the picture is similar to the course of an uncomplicated aneurysm, but more severe pain is noted, accompanied by vomiting and collapse.
In the second stage, when the vessel wall ruptures, massive bleeding occurs, usually leading to death.

Between stages it can take several minutes or several hours.

Modern methods of diagnosis and treatment

Timely diagnosis of aortic aneurysm can save thousands of lives every year. Therefore, it is important, at the first suspicion of this disease, to carry out all available instrumental studies. These include:

Ultrasound of the abdominal cavity;
Survey radiography;
Aortography;
Retropneumoperitoneum.

Considering that the rupture of an aortic aneurysm is highly likely to lead to death, and can occur at any time, so surgical intervention is indicated for patients. Moreover, in patients with a damaged or abdominal aorta, surgery is performed urgently according to urgent indications. However, if the process is at initial stage, and its course is not complicated in any way, a wait-and-see approach to treating the aneurysm with examination every six months may be justified. At the same time, for those suffering from arterial hypertension, taking medications that lower blood pressure becomes truly vital.

Video: definition, diagnosis and treatment options for the disease

Aneurysms of other locations

Despite the fact that if an aneurysm ruptures in a peripheral artery, the consequences will not be so fatal, still intense internal bleeding is serious danger for human life, regardless of in which part of the body it occurs. Let's consider the most common localization of aneurysms in peripheral arteries.

An aneurysm that forms in ascending department aorta. It can affect the section of the artery from the aortic valve to the origin of the brachiocephalic trunk. It often has a spindle-shaped shape and can be complicated by aortic valve insufficiency, and this, in turn, affects the general well-being of a person and the condition of his heart (more about aortic and cardiac aneurysm).
An aneurysm that affects the aortic arch. Its danger lies in the fact that large arterial trunks extend from this part of the main artery towards the head and arms. That is, when the aortic arch is damaged, not only weakness in the arms occurs, but also symptoms appear that signal a violation of cerebral circulation.
Aneurysm of the splenic artery. In terms of frequency of occurrence, it comes immediately after abdominal aortic aneurysm. It is characterized by the fact that the likelihood of rupture increases sharply during pregnancy. Often has inflammatory cause and calcified lesions. The pain is localized in the left upper abdomen.
TO serious complications(up to renal infarctions) can lead renal artery aneurysm. Most often, such injuries are unilateral; the disease can develop in fairly young people against the background birth defects vascular tissues.

Aneurysm of the iliac artery. The danger of this localization is that the iliac artery is the largest after the aorta, which means that if it ruptures, the consequences can be irreversible. The insidiousness of such an aneurysm is that it for a long time can occur without any symptoms, and pain appears when the expansion of the artery reaches a critical size and it begins to put pressure on the internal organs.
For femoral artery aneurysm A pulsating tumor-like formation occurs (often in the groin area). The largest percentage of patients are elderly, and this type of aneurysm is often bilateral. A false aneurysm of this artery is a specific hematoma of a vessel that is formed as a result of injury to the vascular wall.
For aneurysm jugular vein a vascular sac occurs, most often caused by injury. It is a false aneurysm. It is formed mainly after “blunt” closed wounds, less often it occurs with stab and gunshot wounds with a narrow wound channel. Aneurysms of the jugular veins, if they are observed in children, can also be congenital, caused by a violation of the formation of vascular tissues during intrauterine development.

What measures should be taken to prevent the disease?

If a person is diagnosed with an aneurysm, and the doctor chooses a wait-and-see treatment approach, then much depends on the patient’s lifestyle and how disciplined he is in following the doctor’s recommendations.

When atherosclerosis is recognized as the cause of an aneurysm of any vessel, the condition can be improved by directing all efforts to combat this disease. Here, diet comes first in importance. It is worth excluding animal fats, egg yolks, and margarine from your diet as much as possible. Lean meat cooked without fat and ocean fish are welcome. Bread and cereals made from whole grains energize and at the same time cleanse the body. You need to increase the proportion of vegetables and fruits in your diet, since the fiber they contain helps normalize lipid metabolism. From fat cottage cheese, cheese and sour cream should be abandoned and replaced with low-fat dairy products.

Read more, which are also suitable for patients with an aneurysm.

Try to completely avoid drinking alcohol, strong black tea and coffee - these drinks create an abrupt load on the vessels, which can be fatal in case of an aneurysm. Green tea, on the contrary, gently tones blood vessels and has a general strengthening effect. Vegetable oils made from a wide variety of seeds and nuts (don't limit yourself to sunflower) will help diversify your diet. Also, many spices help normalize fat metabolism in the body. These include turmeric, ginger, garlic, and onion.

Fighting hypertension

An important risk factor for aneurysms is arterial hypertension. This is due to the fact that high blood pressure blood provokes rapid thinning of the vascular wall in the area of the aneurysm. And at the moment hypertensive crisis the probability of vessel rupture in this place increases several times. That is why it is important to prevent surges in blood pressure in order to avoid hydrodynamic shock to the diseased vessel.

May be caused by irregular use of antihypertensive drugs. Therefore, it is vitally important for patients with a diagnosed aneurysm to follow their blood pressure medication regimen. Some groups of medications can be taken once a day, others require two or three doses, but if the drug suits you, it does not side effects and the dosage is correctly selected, it is strictly not recommended to interrupt the intake. Where an ordinary hypertensive patient gets away with a headache, a patient with an aneurysm risks his life.

One of the reasons that provoke sharp increase pressure even at relatively healthy people, is stress. If you have nervous work, conflicts in the family or you are just very emotional person, consider keeping it on hand at all times. depressant. Good soft effect without side effects and addiction are provided by modern herbal preparations, which can be purchased at the pharmacy.

Control loads

Sometimes doctors prescribe absolute rest for particularly zealous patients. This should not be taken literally: without physical activity, the vessels deteriorate faster, which means the risk of aneurysm rupture increases.

But you also need to load yourself wisely. If you cannot avoid lifting weights, do not jerk, soberly assess the permissible load. If you are used to running in the morning or walking to Gym, you shouldn’t give up dynamic training altogether - replace running with intense walking, and exercise machines with yoga gymnastics or Pilates.

Nordic walking - great view balanced load

If an aneurysm is found in a person who does not have the habit of regular physical activity, it’s time to start. A simple ten-minute exercise in the morning will invigorate and increase vascular tone, joint exercises without serious stress will improve blood circulation in the arms, legs and spine, and gentle ones will saturate the internal organs with oxygen. Important point: such loads should be systematic, ideally daily.

Stop smoking

This bad habit accelerates the growth of an aneurysm, since the substances contained in tobacco smoke have both a direct and indirect damaging effect on the vessels.

Each puff provokes a new round of spasms. small vessels, including those that feed the aorta and other large arteries. This means that degenerative processes will develop faster. In addition, by directly affecting the muscle layer of the affected artery, tobacco smoke promotes the growth of the area damaged by the aneurysm.

As for the indirect effect of smoking on aneurysms, one should remember the role of tobacco in the development of atherosclerosis. U smoking people the risk of lipid metabolism disorders, the formation of atherosclerotic plaques and, as a consequence, aneurysm is several times higher.

Thus, even simply quitting smoking increases the chances of a long, fulfilling life for patients with an aneurysm.

What can traditional medicine offer?

In some cases, conservative treatment of an aortic aneurysm may be warranted, including folk remedies. Tinctures, herbal teas and some natural products have a beneficial effect on blood vessels, the condition of the heart and the body as a whole.

You can also prepare a very tasty dessert yourself, which will also support the health of your blood vessels:

To do this, you need to mince one lemon, one glass of raisins and nuts, then add a glass of honey and mix thoroughly. You can diversify the mixture by adding dried apricots or figs. Store in the refrigerator and eat 2 teaspoons three times a day.

All have an excellent vascular strengthening effect products containing a large number of vitamin C. So, it’s good to eat a glass of black currants a day; it wouldn’t hurt to include rowan berries, cranberries, blackberries, and strawberries in your diet. During the season, be sure to eat them fresh, and for the winter you can freeze these berries or grind them with sugar (be sure to store them in the refrigerator).
For preparing drinks and salads use lemon(the main thing is not to boil it so that the fragile structure of vitamin C does not collapse). In winter, eat one well-ripened one every day. orange.

Update: December 2018

Currently, the accelerated pace of life, lack of time, constant employment of young and middle-aged people increasingly lead to the fact that a person does not pay due attention to his health, even if something bothers him. However, it should be remembered that many dangerous diseases, causing only slight discomfort at the beginning, can lead to a disastrous outcome as complications develop. This is especially true for abdominal aortic aneurysm.

The aorta is the largest and most important vessel in the human body. This artery carries blood from the heart to other organs and is located along the spine in the chest and abdominal cavities. Its diameter in the abdominal cavity ranges from 15 to 32 mm, and it is in this section that an aneurysm most often (in 80% of cases) develops. An aneurysm is a protrusion or bulging of the vessel wall caused by atherosclerotic, inflammatory or traumatic damage.

The following types of abdominal aortic aneurysms are distinguished:

Abdominal aortic aneurysm occurs in 5% of men over 60 years of age. The danger of an aneurysm is that the thinned wall at the site of the protrusion may not withstand the blood pressure and rupture, which will lead to death. The mortality rate for this complication is high and amounts to 75%.

What can lead to an abdominal aortic aneurysm?

Causes of aneurysm formation:

is the most common cause aneurysms. In 73–90%, protrusion of the wall of the abdominal aorta is caused by the deposition of atherosclerotic plaques with damage to the internal lining of the vessel.
Inflammatory lesions of the aorta for tuberculosis, syphilis, mycoplasmosis, nonspecific aortoarteritis, bacterial endocarditis, rheumatism.
Genetic disorders, causing weakness of the vascular wall (connective tissue dysplasia, Marfan syndrome).
Traumatic damage to the vascular wall may occur after closed injuries to the abdomen, chest or spine.
Postoperative false aneurysms from anastomoses can extremely rarely form after operations on the aorta.
Fungal (mycotic) lesions of the aorta in persons with immunodeficiency (HIV - infection, drug addiction) or due to the entry of a fungal pathogen into the blood (sepsis).

Risk factors for aortic atherosclerosis and aneurysm formation:

male gender - men are affected more often than women, although aneurysms also occur in women.
age over 50 – 60 years— as the body ages, the elasticity of blood vessels is impaired, which makes the aortic wall susceptible to damaging factors.
family history– presence of aneurysm, dysplasia in close relatives connective tissue having a genetic predisposition.
smoking has a negative impact on the heart vascular system in general, since the substances contained in cigarettes damage the inner lining of blood vessels, affecting blood vessels, increasing the risk of developing hypertension.
alcohol abuse also provides toxic effect on the vessels.
diabetes mellitus - glucose, which cannot be absorbed by cells from the blood, damages the inner lining of blood vessels and the aorta, promoting deposition
overweight
arterial hypertension(cm. ).

Conditions that provoke aneurysm rupture

injury, for example as a result of a road accident

How does an aortic aneurysm manifest in the abdominal cavity?

An uncomplicated small aneurysm may not manifest itself clinically for several years, and is detected by chance during examination for other diseases. Formation of more significant sizes is manifested by the following signs:

most common symptom aneurysms – dull pain in the stomach of a pulling, bursting nature
discomfort and feeling of heaviness in the left umbilical region
feeling of pulsation in the abdomen
digestive disorders - nausea, belching, unstable stools, lack of appetite
lower back pain, numbness and coldness of the lower extremities

If the patient notices these signs, you should consult a doctor for examination, as they may be symptoms of an abdominal aortic aneurysm.

Examination for suspected aneurysm

In the absence of symptoms, the diagnosis can be made by chance, for example, during an ultrasound scan for diseases of the stomach, intestines, or kidneys.

In the presence of clinical signs aneurysm, the doctor who suspects this disease examines the patient and prescribes additional methods research. Upon examination, pulsation of the anterior abdominal wall is determined in the supine position; upon auscultation of the abdominal cavity, a systolic murmur is heard in the projection of the aneurysm; upon palpation of the abdomen, a volumetric pulsating formation similar to a tumor is palpated.

From instrumental methods are appointed:

Ultrasound and duplex scanning abdominal aorta– allows you to visualize a protrusion in the aortic wall, determine the location and extent of the aneurysm, assess the speed and nature of blood flow in this area, identify atherosclerotic lesion walls and the presence of parietal thrombi.
CT or MRI of the abdominal cavity may be prescribed to clarify the localization of the formation and assess the spread of the aneurysm to the outgoing arteries.
Angiography is prescribed in case of unclear diagnosis based on the results of a previous examination. It consists of injecting a radiopaque substance into a peripheral artery and taking an X-ray after the substance enters the aorta.
abdominal x-ray may be informative if calcium salts are deposited in the walls of the aneurysm and their decalcification has occurred. Then the contours and extent of the protrusion can be traced on the x-ray, since the abdominal part of the normal aorta is not normally visible.

In addition, mandatory studies are carried out - rheumatological tests, etc.

Treatment of abdominal aortic aneurysm

There are no medications that can eliminate an aneurysm. But the patient should still take the medications prescribed by the doctor to prevent high blood pressure, which can cause the aneurysm to rupture, and to prevent further damage to the vascular wall. The following groups of drugs are prescribed:

cardiotropic drugs- Prestarium, Recardium, verapamil, Noliprel, etc.
(drugs that prevent the formation of blood clots) - cardiomagnyl, thromboAss, aspicor, warfarin, clopidogrel. They should be prescribed with caution, as rupture of the aneurysm contributes to further bleeding.
lipid-lowering agents(atorvastatin, rosuvastatin, etc., see) normalize cholesterol levels in the blood, preventing its deposition on the walls of blood vessels (
antibiotics and antifungal agents in inflammatory processes in the aorta.
anti-inflammatory drugs(, corticosteroids - prednisolone) for rheumatic damage to the heart and aorta.
medications aimed at correcting glucose levels in diabetes mellitus, etc.

Effective treatment of the disease is carried out only by surgery. The operation can be performed on a planned or emergency basis.

The indication for elective surgical intervention is an uncomplicated aneurysm larger than 5 cm. Emergency surgery is performed for aortic dissection or rupture.

In both cases, the operation is performed under general anesthesia with the connection of a heart-lung machine. An incision is made in the anterior abdominal wall with access to the abdominal aorta. After this, the surgeon applies clamps above and below the protrusion, excises the walls of the aneurysm and sutures an artificial prosthesis to the intact areas of the aorta above and below the aneurysm.

The prosthesis is a synthetic tube that takes root well in the body and does not require replacement throughout a person’s life. Sometimes a prosthesis, bifurcated at the end, is used to replace the aorta below the site of its bifurcation in case of damage to the iliac arteries. The operation lasts about 2 – 4 hours.

After suturing the surgical wound, the patient is transferred to the intensive care unit, where he is under observation for up to 5–7 days. After this, another two to three weeks or longer, depending on the course of the postoperative period, remains in the specialized department, and is discharged home under the supervision of a cardiologist and cardiac surgeon at the clinic at the place of residence.

Contraindications for elective surgery

Due to the fact that when preparing for a planned intervention, the patient and the doctor have time, unlike a complicated aneurysm, the patient can be carefully examined taking into account possible contraindications and assessment of the body’s compensatory capabilities.

There are no contraindications for emergency surgery, since the surgical risk is several times less than the mortality rate from complications of the aneurysm, therefore any patient with suspected aneurysm rupture should be taken to the operating table.

In the 90s of the last century, Argentine scientists tested a device for aortic replacement called a stent graft. This is an aortic prosthesis, which consists of a trunk and two legs, guided by a catheter under X-ray television control through the femoral artery to the aneurysm and self-reinforced in the walls of the aorta with special hooks.

The operation is endovascular and is performed without an incision in the anterior abdominal wall under local or general anesthesia. Duration 1 – 3 hours.
Advantages of aortic replacement– low morbidity compared to open surgery, and more fast recovery body.
Disadvantages - due to the fact that the aneurysm itself is not excised, but the prosthesis is inserted as if inside the protrusion, the aneurysm continues to exist. Gradually, the protrusion of the aortic wall spreads above the stent attachment site, which leads to the development of new blood flow paths, the formation of blood clots, dissection of the vessel wall, and, as a result, increases the risk of complications. Often these processes require normal operation, therefore, despite good results V early period after endoprosthetics, it is performed less frequently than open surgery.

The mass distribution of endoprosthetics is limited by the considerable costs of the clinic for the purchase of graft stents (the cost of one prosthesis abroad is about 500 thousand rubles, the cost of the operation itself is 20 - 40 thousand rubles), especially since the stent must be made individually for a specific patient. In Russia this operation refers to high-tech types of care, and in some clinics it is carried out according to quotas of the Ministry of Health of the Russian Federation. Open operations, especially in an emergency, are carried out free of charge.

Complications after surgery

Mortality after elective surgery 0 – 0.34% per year in long term.
Mortality after operated rupture of an aneurysm in the first two months is 90%.
Operative mortality varies greatly:
- for planned operations it is 7 – 10%;
- during operations for aneurysm rupture - 40 - 50%;
- for endoprosthetics – 1%.

The statistics presented and the experience of surgeons show that a planned operation is much preferable for the patient, since delay in the presence of indications for surgery is fraught with a threat to life. But even with careful preparation of the patient and assessment of surgical risks, the development of complications after surgery cannot be ruled out. They develop rarely and account for less than 4%.

Complications in the early postoperative period

pulmonary edema
cerebral edema
renal failure
dehiscence and inflammation of the surgical wound
blood clotting disorders and bleeding in internal organs
in endoprosthetics – endoleaks, or leakage of the installed prosthesis
thromboembolic complications - separation and entry of blood clots into the arteries of the intestine, lower extremities, brain, and pulmonary artery.

Prevention of complications is a careful selection of the prosthesis, intensive monitoring of the patient in postoperative period, taking antibiotics, prescribing heparin according to a standard surgical regimen.

In the long term there are

prosthesis infection (0.3 – 6%)
prosthetic intestinal fistula (less than 1%)
prosthesis thrombosis (3% within 10 years after surgery)
sexual dysfunction (less than 10% in the first year after surgery)
postoperative hernia.

Prevention of long-term complications - prescribing antibiotics for any invasive examinations, dental, gynecological and urological procedures, if they are accompanied by penetration into body tissues; lifelong use of statins, antiplatelet agents, beta blockers and ACE inhibitors. Impotence can be prevented by carefully isolating the iliac arteries and aorta at the time of surgery so as not to damage nearby nerves.

What is the danger of an abdominal aortic aneurysm without surgery?

This disease is fraught with the development of life-threatening complications, such as dissection, rupture or thrombosis of the aorta.

Dissecting aneurysm of the abdominal aorta

It is caused by the gradual thinning of the walls of the aorta and the penetration of blood into the wall of the vessel, stratifying its membranes. Such a hematoma spreads further and further until the wall bursts under the influence blood pressure and the aorta will not rupture.

Aortic rupture

There is a breakthrough of blood from the aorta into the abdominal cavity or retroperitoneal space. Symptoms, diagnosis, and treatment are similar to those of dissecting aortic aneurysm. State of shock and death are caused by massive blood loss and cardiac dysfunction.

Aneurysm thrombosis

Rarely, complete blockage of the entire lumen by thrombotic masses develops; mainly, the formation of parietal thrombi occurs, which, with the blood flow, can be transferred to smaller arteries and cause blockage of their lumen (renal, iliac arteries, arteries of the lower extremities).

signs: with renal artery thrombosis - sudden severe pain in the lower back, lack of urination, general bad feeling, nausea, vomiting; with thrombosis of the iliac and femoral arteries - sudden coldness of the lower extremities (one or both), intense pain, rapid blueness of the skin of the legs, impaired motor function.
diagnostics: ultrasound and duplex scanning
Treatment: anticoagulant therapy, surgical removal of the blood clot.

What lifestyle should a patient with an abdominal aortic aneurysm lead?

Before surgery. If the aneurysm is small (up to 5 cm), and is not planned elective surgery, doctors take a wait-and-see approach and monitor the patient. The patient should visit the doctor every six months for examination; if the aneurysm grows rapidly (more than 0.5 cm per six months), he will be scheduled for surgery.

After surgery, the patient visits the doctor monthly in the first year, then every six months in the second year and then once a year.

Both before and after surgery, the patient must take medications prescribed by the doctor. It is recommended to follow the following simple steps to maintain a healthy lifestyle to prevent aneurysm growth and complications:

Proper nutrition and reduction overweight . Avoid fatty, fried, spicy, salty food. Animal fats and confectionery products are limited. Recommended fresh vegetables and fruits, cereals, dairy products, low-fat varieties poultry, meat and fish, juices, compotes, fruit drinks. Eating 4 – 6 times a day, in small portions. It is better to cook products in steamed, boiled, pureed form.
Reducing cholesterol levels– taking statins as prescribed by a doctor.
Monitoring blood pressure levels– exclusion of psycho-emotional stress, severe physical labor, regular intake medications that normalize blood pressure, limiting sodium in food.
Complete cessation of smoking and alcohol. It has been proven that smoking provokes the growth of an aneurysm, and alcohol increases blood pressure, which can provoke a vascular accident.
Avoiding significant physical activity(in early postoperative period complete bed rest with gradual recovery motor activity). Sports activities are contraindicated. Walking for short distances is acceptable.
Correction of concomitant diseases- diabetes mellitus, heart, liver, kidney diseases, etc.

Disease prognosis

The prognosis without treatment is unfavorable, since the natural course of the disease leads to complications and death.

The mortality rate with small aneurysms (up to 4–5 cm) is less than 5% per year, and with sizes 5–9 cm or more – 75% per year.
The mortality rate after the discovery of a medium and large aneurysm in the first two years is high and amounts to 50–60%.
The prognosis after aortic rupture is extremely unfavorable, since 100% of patients without treatment die immediately, and 90% in the first two months after surgery.
Forecast after planned treatment favorable, 5-year survival rate after surgery is high 65-70%.

The aorta is the largest unpaired artery. It belongs to the large circulation and supplies all organs of our body with blood. The aorta is divided into 3 sections and 2 parts - abdominal and thoracic. Most often (in 95% of cases) an aneurysm of the abdominal aorta occurs, which we will talk about today.

An aneurysm is an enlargement or bulging of the aorta. This disease is still the basis of many discussions, because doctors cannot come to a unanimous opinion on what degree of expansion of the vascular wall can be diagnosed as an aneurysm. Previously, the diagnosis was confirmed when the aorta doubled in size or when its diameter expanded by more than 3 cm. But given that the aorta has a diameter from 15 to 32 cm, the concept of “more than 3 cm” is clearly quite vague. Therefore, in 1991, thanks to a study by American scientists, an aneurysm began to be considered a pathological expansion of the lumen of the aorta 50% larger than its normal diameter. But this definition remains rather conditional.

This question becomes especially important when choosing surgical tactics, however, alas, it still remains open. Meanwhile, about 15,000 Americans die each year from aneurysms. In most cases, it simply does not have time to be diagnosed.

Which doctor treats an aneurysm?

This disease is treated by a vascular surgeon, since the main treatment for the problem is surgical. If surgery is not indicated, the patient should be observed by a therapist, cardiologist or internist (specialist in internal medicine), and carefully monitor his condition. An aneurysm is quite insidious; it can begin to grow suddenly, increasing the risk of its most serious complication - rupture.

Who is at risk?

Aneurysm is diagnosed in both men and women (in the latter, however, much less often). However, it has been noted that it occurs more often in men over 65 years of age. This is largely due to the passion of many for smoking, which is especially harmful in old age.

So, the risk group includes:

people suffering from arterial hypertension;
smokers;
persons whose family has already been diagnosed with an abdominal aortic aneurysm or other cardiovascular diseases and/or pathologies of peripheral circulation;
overweight people and people who lead sedentary lifestyle life.

Attention! Research shows that many aneurysms are inherited from ancestors.

Types of abdominal aortic aneurysms: classification

Abdominal aortic aneurysm is divided into several types depending on its shape, location and pathological features:

Saccular (resembles a sac, which is connected through the neck to the lumen of the aorta).
Fusiform. The shape resembles a spindle, which through an opening is connected to the lumen of the aorta. The most common form of aneurysm.

By pathological features The following types of aneurysms are distinguished:

True. The wall of the vessel is expanded, as it is formed from many layers of the aorta.
Pseudoaneurysm. Appears after injury due to the development of a pulsating hematoma.
Delaminating. That is, its walls are stratified, and the cavities are filled with an intramural hematoma, which through the wall of the damaged vascular tissue is connected to the lumen of the aorta.

It is also distinguished by localization:

Aneurysm of the infrarenal abdominal aorta is located above/below the branch renal arteries.
Suprarenal is located above the branching of the arteries
A total aneurysm spreads along the entire length of the vessel.

What are the causes of an aneurysm?

Atherosclerosis, in which vascular wall becomes thick and loses elasticity, and fat forms on its walls in the form of atherosclerotic plaques. The composition of the plaques includes bad cholesterol and other fats. So far, doctors have not fully determined how exactly atherosclerosis affects the development of an aneurysm, but it is assumed that as a result of this disease, circulatory disorders appear in the vessel and the supply stops nutrients. As a result, the vascular tissue is damaged, followed by its splitting. As a result, a diagnosis of “abdominal aortic aneurysm” is made.
Diabetes mellitus, which “loves” to affect the blood arteries. It is often accompanied by retinopathy, nephropathy, and aneurysm.
Genetics. For some congenital syndromes(Ehlers-Danlos, Marfan, Erdheim's cystic medianecrosis, etc.) arteries are affected, including the abdominal aorta. It is often possible to trace the relationship between abdominal aortic aneurysm and genetic diseases.
Infectious diseases. These include diseases that affect inner layer heart (endocardium), - syphilis, ecdocarditis, salmonellosis, etc.
Injuries received in the abdomen. For example, when strong impact the aorta may be affected in the chest or abdomen.
Inflammatory processes. for example, causes weakening of the aortic wall. True, no specific information on this issue Not yet. But non-inflammatory diseases of the vascular wall often arise due to atherosclerotic plaques.

In general, the most common causes of aneurysm development are smoking, physical inactivity and age. It is extremely important to diagnose it in time. Aneurysms of the thoracic and abdominal aorta have different symptoms, which we will now consider.

What are the symptoms of an abdominal aortic aneurysm?

Most often, an aneurysm does not make itself felt at all and is diagnosed completely accidentally during an examination. Since it displaces organs, disrupting their vital functions, the diagnosis may be made incorrectly, therefore it is extremely important to conduct an ultrasound of the abdominal cavity. Doctors note that aneurysm is especially “secretive” thoracic. It may not appear at all or cause chest pain, coughing and shortness of breath. If it increases, an aneurysm of the abdominal aorta becomes relevant.

Of the few symptoms of an aneurysm, there are several that occur together or separately:

Heaviness in the abdominal area, an unpleasant feeling of fullness and a pulse that resembles an increased heart rate.
Abdominal pain, not acute, rather aching, stupid character. It is localized directly in the navel area or to the left of it.

AND indirect signs An aneurysm of the abdominal aorta makes itself felt. Its symptoms are so different that it is very difficult to suspect a true problem in them. This is because a growing aneurysm can interfere with the functioning of different organs and systems. As a result, it can be confused with renal colic, pancreatitis or radiculitis.

Ischioradicular syndrome causes pain in the lower back (particularly the lower back) and impaired sensation in the legs along with movement disorders.

Abdominal syndrome is manifested by vomiting, belching, diarrhea or constipation, as well as lack of appetite, which entails weight loss.

Chronic ischemia of the legs is expressed in poor circulation (cold legs), muscle pain while walking and at rest, and periodic lameness.

Urological syndrome manifests itself through urination disorders, pain, a feeling of heaviness in the lower back, and even the appearance of red blood cells in the urine.

Rupture of an abdominal aortic aneurysm begins with increased pain in the abdomen, general weakness and dizziness. Sometimes the pain radiates to the lower back, groin or perineum. In this case, the patient needs immediate medical attention, as the condition is fraught with death. Often the aneurysm ruptures in middle section small intestine, stomach or duodenum, less often - into the large stomach. When an abdominal aortic aneurysm ruptures, symptoms may include nausea and vomiting. A mass is palpated in the left, slowly enlarging and with strong pulsation. Its boundaries cannot be felt.

When an aneurysm ruptures, the symptoms are very vivid, but they are easily confused with other health-threatening conditions, so for any acute pain in the stomach or chest, be sure to call ambulance.

Diagnosis of the disease

The first diagnostic stage is an examination by a doctor who, upon palpation, feels strong pulsation in the abdomen, this is an aneurysm of the abdominal aorta. Its diagnosis includes studies that allow you to visualize what is happening in the body. First of all, this is ultrasound, as well as multispiral CT scan aorta (MSCT).

If an abdominal aortic aneurysm is suspected, ultrasound makes it possible to confirm its presence with almost one hundred percent certainty. It shows the exact location of the aneurysm, the condition of the vascular wall, and the location of the rupture, if any.

A CT or MSCT is performed to identify calcification, dissection, intrasaccular thrombosis, threatened rupture or an existing rupture.

If the above diagnostic studies do not allow an accurate diagnosis (although this happens quite rarely), aortography is prescribed. The method allows you to examine the aorta and its branches in real time by introducing a special liquid into the vessel. It is indicated if there is a suspicion of damage to the visceral and renal arteries, and the condition of the distal bloodstream is unknown.

Complications of abdominal aortic aneurysm

This condition is dangerous not only for health, but also for life. First of all, the aorta can cause embolism (blockage) of the arteries, infectious complications, develop heart failure.

Dissecting aneurysm of the abdominal aorta - dangerous complication, which consists in its rupture and blood entering the layers vascular body. If all 3 layers are dissected and the aorta ruptures completely, intense blood loss occurs.

But, of course, the most terrible complication an aneurysm is its rupture. Many patients with untreated aneurysm die within 5 years. Before a breakup a person feels severe pain in the lower abdomen and lumbar region. If an abdominal aortic aneurysm is ruptured, the course of the disease is characterized by profuse bleeding, which leads to shock and death. Therefore, if you have acute pain in the abdomen and chest, be sure to call an ambulance, as it is dangerous to hesitate. Statistics show that only 3% of patients die immediately after aortic rupture, while others live from 6 hours to 3 months. In most cases, they die within 24 hours. How is an aneurysm treated? Let's look at it below.

Treatment of abdominal aortic aneurysm

Many people mistakenly believe that when diagnosed with “abdominal aortic aneurysm,” treatment can only be surgical. In fact, everything is individual here.

If the aneurysm does not reach 4.5 cm in diameter, then surgery is not indicated, because it itself may carry a greater risk to life than the enlarged vessel itself. Typically, this tendency is observed in older men who suffer from concomitant diseases and, in addition, do not stop smoking (and with such a diagnosis, it is simply necessary to stop smoking!). For them, a wait-and-see approach is preferable, because the risk of aortic rupture with this diameter is only about 3% per year. In this case, once every six months the patient is forced to undergo an ultrasound to find out the size of the aorta. If the vascular wall gradually expands, then this is the main indication for surgery, because the likelihood of its rupture increases by 50%.

For elderly people who have been diagnosed with an abdominal aortic aneurysm, it is advisable to treat them using endovascular, minimally invasive method. During the operation, a catheter is inserted into the patient's artery, through which a stent is inserted. Once in the aorta, it opens and clasps the artery, thereby replacing the affected area of its body. The advantages of the operation include easier tolerability and small recovery period- just a few days. But this method also has its own nuances, so it is not suitable for everyone. The main disadvantage of this operation is that in 10% of cases distal migration of the installed stand is observed.

If a diagnosis of abdominal aortic aneurysm is made, the operation is often open. During this procedure, the affected area of the aorta is removed and replaced with a prosthesis made of Dacron (polyester-based synthetic fabric). To provide access to the aorta, a midline laparatomy is used. The duration of the operation is usually about 2-3 hours. After surgery, a noticeable scar remains.

The patient recovers for about two weeks. Resumption labor activity in some cases it is possible only after 4-10 weeks. The patient is strictly prohibited from physical activity and is advised to rest and walk.

Contraindications to open surgery

Surgery is prohibited for the following conditions:

Recent heart attack (at least a month).
Heart and pulmonary failure.
Kidney failure.
Affected iliac and

Rehabilitation period after surgery

Of course, the presence of complications after surgery is influenced by age and accompanying illnesses patient. Also, the patient’s condition may worsen if his body is already weakened (HIV, cancer, diabetes), obesity and heart disease occur. Moreover, surgery planned in advance gives the patient a better chance of survival and recovery than emergency intervention for a ruptured aortic aneurysm.

Complications can manifest themselves as a reaction to general anesthesia, which not everyone can tolerate, the development of infection, damage internal organs and bleeding. In a very small number of cases, the operation ends in death.

If an operation is planned, doctors recommend stopping taking blood thinners and anti-inflammatory drugs (aspirin, etc.) a week before the operation. Be sure to inform your doctor about what medications you are currently taking before surgery.

The risk of relapse is extremely small, but if a person suddenly begins to experience pain in the back or abdomen, nausea, vomiting, numbness in the legs or general poor health, you should immediately consult a doctor.

Prevention of aneurysm

You are less likely to develop an abdominal aortic aneurysm if you give up (and ideally do not acquire this habit at all) smoking, control your blood pressure and your weight. It is also important to lead an active and healthy lifestyle. Be healthy!