[Specific medical strategy for aneurysm of the abdominal aorta]

An analysis of results of treatment of 323 patients with aneurysm of the abdominal and thoraco-abdominal parts of the aorta was made for the period from 1995 through 2010. The patients' age was within the limits from 45 to 88 years and was 67.2 +/- 6.5 at an average. In 65 (24.5%) patients the diagnosis of progressing type aneurysmatic disease of the aorta and other main arteries was made. At the department of surgery of vessels of the Yaroslavl regional clinical hospital (YRCH) planned operations were performed on 102 (31.6%) patients, by emergency indications--on 69 (21.3%), with the clinical picture of rupture on 25 (7.8%) patients. In addition, 58 (17.9%) patients were operated by emergency indications under conditions of the Central regional hospital (CRH). Dynamic follow-up was fulfilled in 69 (21.4%) cases. Results of the operative treatment in greater degree depended on the emergency of surgery and severity of the concomitant pathology. Common lethality after planned operations was 5.9%, emergent--20.3%, aneurysm rupture under conditions of CRH--91.4% of cases. Lethality in YRCH in emergent operations was considerably lower--52% of cases. Use of screening examinations in groups of risk beginning from 50 years of age and the population older than 60, active surgical strategy in small aneurysms, introduction of minimally traumatic operative approaches allow improvement of results of the treatment.