Atherosclerotic aneurism

Description:

Atherosclerotic aneurism is an expansion of the site of an artery which is followed by thinning of a wall of a blood vessel and the increased risk of a rupture of an artery with development of the dangerous bleeding created against the background of atherosclerosis.

Symptoms of Atherosclerotic aneurism:

In 75% of cases these aneurisms are located below renal arteries. There are no complaints usually, aneurism is accidentally found at ultrasonography, a X-ray analysis of a stomach or a physical research, it represents the painless  pulsing education. Complaints to  a strong pulsation in a stomach and  a back pain are possible. Occasionally, at an aorta wall anguish, there are  severe pain and  morbidity at a palpation. The rupture of aneurism leads to  an acute pain and  shock, in such cases the immediate surgery is necessary.

On the roentgenogram happens calcification on the outer edge of aneurism is visible, but in 25% of cases there is no calcification and the X-ray analysis gives nothing. By means of ultrasonography it is possible to measure the longitudinal and cross sizes of aneurism, to find pristenochny blood clots. Ultrasonography is used for observation of the aneurism sizes in dynamics and by inspections of people with high risk of an aortic aneurysm: brothers and sisters sick and that who have an atherosclerosis or aneurisms of peripheral arteries.

Reasons of Atherosclerotic aneurism:

As etiological factor at this pathology atherosclerosis of vessels acts.

Treatment of Atherosclerotic aneurism:

Irrespective of the sizes of aneurism of a ventral aorta its bystry increase and existence of complaints - indications to aneurysmectomy and prosthetics of an aorta. In the absence of complaints operation is shown when diameter of aneurism exceeds 6,5 cm. If there are no serious associated diseases, operation is recommended sometimes also with a diameter of aneurism of 4-5 cm. In other cases are limited to noninvasive observation of the aneurism sizes.

Before operation conduct careful examination, especially cardiovascular system, associated diseases treat. The ischemic heart disease, heart failure, HOZL, a diabetes mellitus and advanced age increase risk of operation. To reveal patients to whom simultaneous surgical treatment of an ischemic heart disease is shown carry out load ECG tests, a myocardium stsintigrafiya with 201Tl with loading or stress-EhoKG. For detection of bezbolevy ischemia of a myocardium holterovsky monitoring of an ECG is shown.

During operation establish a catheter of Svana-Gantsa and an arterial catheter to watch KDD in a left ventricle, cordial emission and the ABP, especially during imposing of a clip on an aorta and its removals, and also in the early postoperative period. Performance of all these actions reduces an operational lethality to 1-2%.

The lethality at immediate surgeries concerning a rupture of aneurism exceeds 50%.