Angiologiia i sosudistaia khirurgiia = Angiology and vascular surgery · 2024
[Penetrating atherosclerotic ulcers of the aorta and iliac arteries (case report)].
Клинический случайАннотация на английскомСтатьяНазвание и аннотация: Оригинал на русском
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Zotov S P, Fokin A A, Skorobogachev R V, Sazanov A V, Markelov A V, Verbenko A S
Аннотация
BACKGROUND: One of the most dangerous manifestations of atherosclerosis is acute aortic syndrome, in particular, a penetrating atherosclerotic aortic ulcer. According to a number of sources, the incidence of penetrating aortic ulcers varies from 2 to 7% of all cases of acute aortic syndrome. In turn, acute aortic syndrome occurs in 30 cases per million people per year. Penetrating atherosclerotic ulcers are most often localized in the descending thoracic aorta, however, some authors point out their possible localization in the abdominal aorta and iliac arteries with a variety of clinical manifestations and the likelihood of wall rupture.
OBJECTIVE: To demonstrate variants of the clinical course and necessity of performing emergency operations in detection of penetrating aortic ulcers localizing in various portions of the aorta and also in the iliac arteries.
MATERIAL AND METHODS: We analyzed case histories of patients with penetrating atherosclerotic ulcers, in particular, the results of instrumental methods of study (multislice computed tomography of the thoracic, abdominal aorta and iliac arteries), also evaluating histological characteristics of the obtained biopsy materials. Literature search for additional information, as well as its systematization and analysis were carried out with the help of scientific literature sources included in the PubMed, Web of Science, eLibrary databases.
STUDY DESIGN: a retrospective study.
RESULTS: In the course of practical work, we analyzed three clinical cases of a penetrating atherosclerotic ulcer of the descending aorta, infrarenal aorta, and iliac arteries.
CONCLUSION: Multislice computed tomography is the gold standard in the diagnosis of penetrating atherosclerotic ulcers. Urgent surgical interventions on the aorta are not indicated for many patients; in such cases, watchful waiting is feasible. In the presence of small saccular aneurysms, it is possible to implant a stent graft, however, when symptoms indicating a threat of aortic rupture appear, open surgical intervention is the prevailing tactics. A clinic providing emergency care to patients with cardiovascular diseases should have a consignment warehouse of consumables for emergency or urgent endovascular operations, including deployment of stent grafts at various levels of the aorto-arterial system.
OBJECTIVE: To demonstrate variants of the clinical course and necessity of performing emergency operations in detection of penetrating aortic ulcers localizing in various portions of the aorta and also in the iliac arteries.
MATERIAL AND METHODS: We analyzed case histories of patients with penetrating atherosclerotic ulcers, in particular, the results of instrumental methods of study (multislice computed tomography of the thoracic, abdominal aorta and iliac arteries), also evaluating histological characteristics of the obtained biopsy materials. Literature search for additional information, as well as its systematization and analysis were carried out with the help of scientific literature sources included in the PubMed, Web of Science, eLibrary databases.
STUDY DESIGN: a retrospective study.
RESULTS: In the course of practical work, we analyzed three clinical cases of a penetrating atherosclerotic ulcer of the descending aorta, infrarenal aorta, and iliac arteries.
CONCLUSION: Multislice computed tomography is the gold standard in the diagnosis of penetrating atherosclerotic ulcers. Urgent surgical interventions on the aorta are not indicated for many patients; in such cases, watchful waiting is feasible. In the presence of small saccular aneurysms, it is possible to implant a stent graft, however, when symptoms indicating a threat of aortic rupture appear, open surgical intervention is the prevailing tactics. A clinic providing emergency care to patients with cardiovascular diseases should have a consignment warehouse of consumables for emergency or urgent endovascular operations, including deployment of stent grafts at various levels of the aorto-arterial system.