Angiologiia i sosudistaia khirurgiia = Angiology and vascular surgery最新文献

{"title":"[Histological changes of the aortic wall in the area of the proximal neck of an aneurysm upon rupture].","authors":"T N Khafizov, V V Kataev, A M Shumkin, S V Shchekin, B I Zagidullin, V R Manylova, R R Khafizov, T E Imaev","doi":"10.33029/1027-6661-2026-32-1-10-15","DOIUrl":"https://doi.org/10.33029/1027-6661-2026-32-1-10-15","url":null,"abstract":"<p><strong>Objective: </strong>To study the state of tissues of the aortic wall in the area of the proximal neck of an aneurysm in patients with lethal outcomes due to aneurysmal rupture.</p><p><strong>Materials and methods: </strong>A fragment of the aortic wall for histological examination was procured from the area of the proximal neck of aneurysms in 16 patients who died from ruptured aneurysms of the abdominal and thoracic aorta. The fragment of the aortic wall to study was taken at a distance from 1 to 4 cm above the upper pole of the aneurysm. The specimens after being treated with phosphotungstic acid were stained with hematoxylin and eosin, aniline blue.</p><p><strong>Results: </strong>Damage to all layers of the aortic wall was revealed at a distance of 1 cm from the upper pole of the aneurysm. The most pronounced changes were observed in the medial layer. At a distance of 2 cm from the upper pole of the aneurysm, the aortic wall was found to contain atherosclerotic plaques circumscribed by a thick, dense layer of collagen fibers with diffuse hyalinosis. At a distance of 3 cm from the upper pole of the aneurysm, there was a decrease in the severity of the lesion of the aortic wall. At a distance of 4 cm from the upper pole of the aneurysm, in the media predominated foam cells, visualizing pronounced medial atrophy, with replacement of elastic fibers by coarse collagen fibers.</p><p><strong>Conclusion: </strong>In patients with ruptured aortic aneurysms, the structural integrity of the aortic wall begins at a distance of 4 cm above the upper pole of the aneurysm, which should be taken into consideration when performing surgical treatment.</p>","PeriodicalId":7821,"journal":{"name":"Angiologiia i sosudistaia khirurgiia = Angiology and vascular surgery","volume":"32 1","pages":"10-15"},"PeriodicalIF":0.0,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148248858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Explantation of the abdominal aortic bifurcation endoprosthesis for type I endolymer (clinical case)].","authors":"A N Pankov, N L Bayandin, K V Getazheev, I D Zemlyannikov, S P Semitko, D G Ioseliani","doi":"10.33029/1027-6661-2026-32-1-143-147","DOIUrl":"10.33029/1027-6661-2026-32-1-143-147","url":null,"abstract":"<p><p>Endovascular treatment of patients with abdominal aortic aneurysm is a minimally invasive alternative to open surgery with lower hospital mortality and rapid postoperative recovery. The maximum benefits are achieved in the elderly and comorbid patients with high surgical risk. However, long-term complications such as endolics and stent graft infection may require repeated interventions. The article presents a clinical observation of the occurrence of type I endolycosis 10 years after endovascular correction of an aortic aneurysm (EVAR) with suspected infection of the prosthesis. Stent graft explantation and aorto-femoral bifurcation prosthetics with a synthetic prosthesis were performed. The described case demonstrates the importance of a multidisciplinary approach and the use of modern imaging techniques for timely diagnosis and selection of optimal treatment tactics.</p>","PeriodicalId":7821,"journal":{"name":"Angiologiia i sosudistaia khirurgiia = Angiology and vascular surgery","volume":"32 1","pages":"143-147"},"PeriodicalIF":0.0,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148248787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Carotid-axillary prosthetics as a surgical treatment option for subclavian artery aneurysm (clinical case)].","authors":"A V Marchenko, P A Myalyuk, D A Korotaev, N V Kdralieva, V A Belov","doi":"10.33029/1027-6661-2026-32-1-132-136","DOIUrl":"10.33029/1027-6661-2026-32-1-132-136","url":null,"abstract":"<p><p>Subclavian artery aneurysm is rare. There are no recommendations for surgical treatment for this localization of aneurysms. Depending on the anatomy of the aneurysm itself and the surrounding tissues, treatment can be either open surgical or endovascular. The presented clinical case demonstrates successful surgical treatment in the amount of carotid-axillary prosthetics if the patient has contraindications to endovascular intervention.</p>","PeriodicalId":7821,"journal":{"name":"Angiologiia i sosudistaia khirurgiia = Angiology and vascular surgery","volume":"32 1","pages":"132-136"},"PeriodicalIF":0.0,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148249001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Prosthetic repair of the ascending aorta and aortic arch from the left-sided thoracotomy in a female patient after pulmonectomy (clinical case report)].","authors":"E R Charchyan, A O Goryagin, G S Khramchenkov, D A Chakal, Yu V Belov","doi":"10.33029/1027-6661-2026-32-1-154-158","DOIUrl":"10.33029/1027-6661-2026-32-1-154-158","url":null,"abstract":"<p><p>Described herein is a clinical case of successful prosthetic repair of the aortic valve, ascending aorta and aortic arch according to the hemiarch technique from the left-sided thoracotomy. A 69-year-old female patient presented with an aneurysm of the ascending aorta and proximal aortic arch, a combined defect of the aortic valve and pronounced displacement of the mediastinal organs due to pulmonectomy performed in 2001. The classical procedure of the operation from the median sternotomy would be associated with technical difficulties and a high risk of lung injury owing to displacement of the mediastinum to the left, therefore left-sided lateral thoracotomy was chosen, thus making it possible to perform full-scope surgical treatment without exposure deterioration. The woman was discharged with no complications on POD 7 and rapidly rehabilitated. Precise knowledge of the anatomical location of the aorta and cardiac structures plays a large part in planning of the operation. That is why it is necessary to underline the importance of thorough preoperative CT planning prior to interventions on the thoracic portion of the aorta, with the use of alternative approaches in non-standard anatomy making it possible to avoid unexpected difficulties and complications during interventions on the thoracic aorta.</p>","PeriodicalId":7821,"journal":{"name":"Angiologiia i sosudistaia khirurgiia = Angiology and vascular surgery","volume":"32 1","pages":"154-158"},"PeriodicalIF":0.0,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148248887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Technical aspects of the primary retrograde endovascular intervention in patients with chronic limb threatening ischemia].","authors":"S A Platonov, V N Zhigalo, G V Mkrtchyan, A Sh Alisultanov, M A Kiselev, D V Kandyba","doi":"10.33029/1027-6661-2026-32-1-122-131","DOIUrl":"https://doi.org/10.33029/1027-6661-2026-32-1-122-131","url":null,"abstract":"<p><p>The aim was to evaluate the efficacy and safety of primary retrograde endovascular intervention in patients with necrotic lesions of the foot caused by chronic limb threatening ischemia.</p><p><strong>Objective: </strong>The analysis of the results of 68 primary retrograde interventions in 64 patients with ischemic necrosis of the foot was performed. The average age was 69.2±9.7. Occlusion of the femoropopliteal segment occurred in 72.1% of observations. At least one crural artery was occluded in 79.4% of cases. There was a two-level occlusive lesion in 58.8% of observations, a three-level occlusion in 2.9%. Access was performed at the distal third of the crural arteries in 95.6% of cases. Access was performed through the sole patent crural artery in 25% of observations. The sole patent vessel was also feeding artery for affected angiosome in 14.7% of cases. Antegrade recanalization and angioplasty of the 'adjacent' crural artery were performed using primary retrograde distal access in 35 (51.5%) observations. The lesion of the 'adjacent' artery was represented by occlusion in 68.6% of cases. In addition, due to the presence of hemodynamically significant lesion of the proximal segment of the punctured vessel, in 27 (77.1%) observations angioplasty of two crural arteries was performed through the single access.</p><p><strong>Results: </strong>Direct revascularization of the affected angiosome was achieved in 82.4% of observations. Blood supply to the ulcer was restored through the foot collaterals from the non-angiosome artery in 17.6% of cases. Angioplasty of the 'adjacent' crural artery was successful in 100% of observations. It was possible to perform intraluminal recanalization in 41.7% of cases of 'adjacent' artery occlusion (the average lesion length was 3 cm). In 58.3% of cases subintimal angioplasty was performed (the average occlusion length was 11 cm). Femoral access was required to successfully complete intervention in 5.9% of observations. Access site complications (7.4%) were local, occurred without any symptoms and in most cases (4 out of 5) were eliminated without loss of patency of the punctured artery. In one case active measures were not carried out due to good blood supply to the foot from other crural arteries.</p><p><strong>Conclusion: </strong>Primary retrograde endovascular intervention in patients with chronic limb threatening ischemia is effective and safe, including when performing through a sole patent crural vessel and/or when recanalization of the 'adjacent' artery through the distal single access is necessary.</p>","PeriodicalId":7821,"journal":{"name":"Angiologiia i sosudistaia khirurgiia = Angiology and vascular surgery","volume":"32 1","pages":"122-131"},"PeriodicalIF":0.0,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148248894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Methods of great saphenous vein harvesting for coronary artery bypass grafting: а systematic review].","authors":"R N Komarov, I V Lutsenko, O O Ognev, Li Shan, L Z Faradzheva, A A Romanovskii","doi":"10.33029/1027-6661-2026-32-1-186-192","DOIUrl":"10.33029/1027-6661-2026-32-1-186-192","url":null,"abstract":"<p><strong>Objective: </strong>To study, summarize, and conduct a comparative analysis of four currently used methods for harvesting the great saphenous vein during coronary artery bypass grafting surgery.</p><p><strong>Material and methods: </strong>A literature search was conducted using the electronic databases PubMed, eLibrary, and CNKI with specific keywords and inclusion criteria to select articles focused on evaluating the outcomes of different autologous vein graft harvesting techniques.</p><p><strong>Results: </strong>Data from 22 selected scientific publications were analyzed. It was found that, in terms of long-term patency, the no-touch technique showed the best results; the traditional open technique is characterized by the highest number of complications; the endoscopic method provides the best cosmetic appearance of the postoperative scar but is somewhat inferior in terms of long-term graft patency.</p><p><strong>Conclusion: </strong>Currently, the choice of great saphenous vein harvesting technique largely depends on the technical equipment of the operating room and the personal experience of the surgeon. The development of autologous vein graft harvesting techniques reflects key trends in modern medicine aimed at achieving minimal invasiveness, precision, and treatment personalization. Each technique has unique clinical value and areas of application. In the future, with further progress in medical technology, these surgical methods are expected to continue improving, further reducing risks and improving patients' quality of life.</p>","PeriodicalId":7821,"journal":{"name":"Angiologiia i sosudistaia khirurgiia = Angiology and vascular surgery","volume":"32 1","pages":"186-192"},"PeriodicalIF":0.0,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148248846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[The effect of sulodexide on the quality of life of patients with intermittent claudication: results of a multicenter observational study of ANDANTE].","authors":"M R Kuznetsov, I A Suchkov, A V Chupin, V E Barinov, S V Sapelkin, G Yu Sokurenko, E V Barinov, E P Golovan, I A Cheremisina, M A Getman","doi":"10.33029/1027-6661-2026-32-1-36-45","DOIUrl":"10.33029/1027-6661-2026-32-1-36-45","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Relevance: &lt;/strong&gt;Arterial disease of the lower extremities is a common form of atherosclerosis associated with an increased risk of cardiovascular disease and mortality. Arterial disease of the lower extremities tends to progress from asymptomatic forms to intermittent claudication and critical ischemia. Sulodexide therapy in patients with PH allows for increased pain-free walking distance. At the same time, the scientific literature has not fully documented how long-term sulodexide therapy affects the quality of life of patients with arterial disease of the lower extremities. The aim of the study was to evaluate the effect of sulodexide on the quality of life of patients with arterial disease of the lower extremities.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Material and methods: &lt;/strong&gt;The multicenter prospective observational study of ANDANTE included patients with PH stage IIa-IIb according to the classification of A.V. Pokrovsky receiving sulodexide therapy. During the 6-month follow-up, 4 visits were conducted, during which the quality of life was analyzed based on a subjective assessment of physical and mental health using the SF-36 questionnaire. Pain-free walking distance, ankle-shoulder index, self-assessment of erection retention, WELCH walking ability scale scores, and Hasegawa dementia scale scores were also evaluated for men. In this article, we have considered only the dynamics of patients' quality of life in terms of physical and mental health on the SF-36 scale as the primary endpoint of the study. In the future, data on other criteria for the treatment of patients will be presented.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The study included 229 patients aged 37 to 90 years (on average, 65.0±9.9 years). Men prevailed among the patients - 159 (69.4%) patients. There were 118 (51.5%) smokers and 111 (48.5%) non-smokers. The average duration of the disease from the moment of diagnosis of arterial disease of the lower extremities to inclusion in the study was 6.0±6.3 years. In addition to OCD, 72.5% of patients were diagnosed with hypertension, 28.4% with cerebrovascular disease, 26.6% with coronary heart disease, 25.3% with diabetes mellitus, and 19.7% with erectile dysfunction. At the time of inclusion in the study, 61.6% of patients were taking antiplatelet agents, 10.9% were taking direct oral anticoagulants, and 46.3% of patients were taking lipid-lowering therapy. At the time of inclusion in the study, 147 (64.2%) patients followed the recommendations on physical activity. Revascularization before inclusion in the study was performed in 19.2%, and 80.8% were treated conservatively. The study did not record any adverse events during sulodexide therapy. Compliance with therapy was high and averaged 4.6 points on a 5-point scale. The indicators of the physical aspect of the quality of life on the SF-36 scale significantly increased (p&lt;0.01) after 6 months of treatment with sulodexide from 35.7±8.3 points on the first visit, to 44.6±7.2 points on the","PeriodicalId":7821,"journal":{"name":"Angiologiia i sosudistaia khirurgiia = Angiology and vascular surgery","volume":"32 1","pages":"36-45"},"PeriodicalIF":0.0,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148248907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Complications of cerebrospinal fluid drainage after thoracoabdominal aortic surgery (systematic review and meta-analysis)].","authors":"I N Shchanitsyn, V S Arakelyan, V G Papitashvili, N R Oglu Gamzaev, T B Averina, R G Butsello, D Ya Khinchagov, P P Kulichkov","doi":"10.33029/1027-6661-2026-32-1-167-185","DOIUrl":"10.33029/1027-6661-2026-32-1-167-185","url":null,"abstract":"<p><strong>Relevance: </strong>Currently, only one method of spinal cord protection-cerebrospinal fluid (CSF) drainage - has been rated as level 1 evidence in international guidelines for thoracoabdominal aortic aneurysm surgery. However, in recent years, there has been increased attention to complications of CSF drainage, such as intracranial hemorrhage. The aim determination of the frequency and risk factors of complications of CSF drainage during operations for thoracoabdominal aortic aneurysms.</p><p><strong>Material and methods: </strong>A search of publications in the PubMed (Medline), Google Scholar, and Russian Science Citation Index (eLibrary) databases was conducted according to the PRISMA criteria. The ROBINS1 and ROBINS2 scales were used to assess the methodological quality of the studies. The pooled complication rate was calculated using a random-effects model (DerSimonian-Laird). Univariate (subgroup analysis) and meta-regression analyses were performed to assess the influence of the following parameters on the complication rate of CSF drainage: study type, article publication date, surgical approach, target CSF threshold pressure, CSF drainage rate, and CSF drainage method.</p><p><strong>Results: </strong>The final analysis included 71 articles (10.798 patients) published from 1991 to 2024. In general, the methodological quality of the studies was acceptable, the risk of systematic error remained moderate. According to the meta-analysis, the incidence of all complications of CSF drainage was 11.9% (95% CI 9.7-14.1), the incidence of severe complications was 1.7% (95% CI 1.3-2.0), intracranial symptomatic hemorrhage was 1.3% (95% CI 1.0-1.7), and associated mortality was 1.1% (95% CI 0.1-3.1). High heterogeneity of studies and the absence of significant publication bias were noted. A significant increase in the incidence of complications was revealed in later publications. No differences were found in the incidence of CSF drainage complications depending on the type of publication, type of procedure, CSF pressure threshold used, drainage rate, and drainage technique.</p><p><strong>Conclusion: </strong>Due to the high complication rate, a careful assessment of the benefits and risks of CSF drainage is necessary. This study highlights the limitations of the available data, the high prevalence of complications associated with CSF drainage, and the need for further research to determine the true complication rate and evaluate various CSF drainage protocols.</p>","PeriodicalId":7821,"journal":{"name":"Angiologiia i sosudistaia khirurgiia = Angiology and vascular surgery","volume":"32 1","pages":"167-185"},"PeriodicalIF":0.0,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148248643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[The use of regulatory peptides after femoropopliteal bypass grafting above the knee joint space using a synthetic prosthesis].","authors":"I A Suchkov, A V Lyasheva, V O Povarov, R E Kalinin, I V Vezenova","doi":"10.33029/1027-6661-2026-32-1-28-35","DOIUrl":"https://doi.org/10.33029/1027-6661-2026-32-1-28-35","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Currently, for extensive occlusive lesions of the superficial femoral artery, the treatment of choice is femoropopliteal bypass grafting above the knee joint space. In the absence of a suitable autogenous vein or xenograft, synthetic grafts are used. One of the causes of thrombosis in the reconstruction zone after using synthetic grafts for femoropopliteal bypass grafting is the high incidence of restenosis in the anastomotic zone of arterial reconstruction due to endothelial dysfunction. One agent that normalizes endothelial function is a complex of bovine vascular regulatory polypeptides.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study objective: &lt;/strong&gt;To evaluate the effectiveness of using a complex of regulatory polypeptides of bovine vessels after femoropopliteal bypass above the knee joint space with a synthetic prosthesis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Material and methods: &lt;/strong&gt;The study included 60 patients with stage III-IV lower extremity arterial atherosclerosis according to the Fontaine-Pokrovsky classification. They were divided into two groups of 30 patients each. All patients underwent surgery: femoropopliteal bypass grafting above the knee joint space using a synthetic prosthesis made of polytetrafluoroethylene diameter 8 мм. After surgery, patients in Group I, in addition to standard therapy, received one course of a drug based on a complex of bovine vascular regulatory polypeptides according to the instructions for use of Slavinorm® (intramuscular injections of the drug twice a week for 5 weeks, No. 10). Patients in Group II received only standard therapy according to clinical guidelines. To evaluate the effectiveness of treatment of patients, the following were used: measurement of the ankle-brachial index (ABI), ultrasound examination of the zones of the proximal and distal anastomoses of the femoropopliteal bypass, as well as measurement of the pain-free walking distance (PFWD) on the first day, 1, 3, 6, 9, 12 months after surgery.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;In groups I and II, the average ABI value before treatment was 0.46 and 0.44; 1 month after surgery 0.76 and 0.74; 3 months 0.77 and 0.71; 6 months 0.78 and 0.7; 9 months 0.785 and 0.7; 12 months 0.8 and 0.65, respectively. In groups I and II, the average DBH value before treatment was 31.5 m and 23 m; 1 month after surgery 118.5 m and 88 m; 3 months 128.5 m and 87 m; 6 months 128 m and 84 m; 9 months 134 m and 71 m; 12 months 138 m and 66 m, respectively. Changes in ABI and DBH in both groups throughout the entire follow-up period were statistically significant (p&lt;0.001). Twelve months after surgery, the incidence of restenosis in Group I was 7 (11.6%) cases, while in Group II it was 15 (50%) cases. Postoperatively, at various follow-up periods, cases of BPS thrombosis were recorded: 1 (3.3%) case in Group I and 4 cases in Group II (13.3%). According to logistic regression data, in Group II patients who did not receive the bovine vascular polypeptide-based drug, the o","PeriodicalId":7821,"journal":{"name":"Angiologiia i sosudistaia khirurgiia = Angiology and vascular surgery","volume":"32 1","pages":"28-35"},"PeriodicalIF":0.0,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148248859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Challenges in diagnosis and surgical management of rare forms of abdominal aortic aneurysm rupture].","authors":"A A Ivanenko, R V Ishchenko, D A Filimonov, F S Popivnenko, A A Konyashin, A E Glebova","doi":"10.33029/1027-6661-2026-32-1-104-112","DOIUrl":"https://doi.org/10.33029/1027-6661-2026-32-1-104-112","url":null,"abstract":"<p><strong>Background: </strong>Abdominal aortic aneurysms (AAA) occupy the first place by the incidence amongst all aortic aneurysms and are found in 0.1-1.6% of all autopsies. The natural outcome of the AAA course is rupture occurring, according to literature data, in 50-80% of patients Amongst AAAs, there are forms posing great challenges in diagnosis and surgical management due to rarity of the disease and diversity of clinical manifestations.</p><p><strong>Objective: </strong>The purpose of this study was to determine the leading clinical signs of rare forms of AAA rupture and develop optimal surgical tactics of treating them.</p><p><strong>Patients and methods: </strong>At the Department of Vascular Surgery of the 'Institute of Emergency and Restorative Surgery named after V.K. Gusak', we operated on a total of 633 patients with AAAs, of these, 285 (45%) for a ruptured aneurysm. Amongst the latter, there were 22 (7.7%) patients presenting with rare forms of rupture defined as: chronic contained rupture in 7 (2.5%) patients, aneurysmal rupture into the gastrointestinal tract with the formation of an aortoenteric fistula in 6 (2.1%) patients, rupture into the inferior vena cava with the formation of an aortocaval fistula in 6 (2.1%) patients, and a combination of AAA rupture with abdominal aortic dissection in 3 (1%) cases. The main methods of examination included duplex and triplex scanning, Doppler ultrasonography, and in insufficient information, spiral computed tomography (SCT) and SCT-angiography.</p><p><strong>Results: </strong>All 22 patients were operated on. Of these, 9 (40.9%) patients died. The diagnostic peculiarities were as follows: 1. Chronic contained rupture turned out to be difficult to differentiate from a retroperitoneal tumor, both before and during surgery. Two-phase nature of clinical manifestations was characteristic of the clinical course of this variant of rupture. 2. Aortoenteric fistulas were characterized by symptoms of a pulsatile mass in the abdominal cavity, relapsing gastrointestinal bleeding, with negative results of fibrogastroduodenoscopy. 3. Aortocaval fistulas were characterized by systolic-diastolic murmur above the aneurysm and acute right ventricular cardiovascular insufficiency.</p><p><strong>Conclusion: </strong>Diagnosis of rare forms of AAA rupture is a difficult task, the clinical course of the disease is characterized by a wide variety of symptoms, thus leading to delayed rendering of emergency specialized care. Surgical tactics in rare forms of abdominal aneurysm rupture has not yet been standardized and solving this problem requires further accumulation of experience.</p>","PeriodicalId":7821,"journal":{"name":"Angiologiia i sosudistaia khirurgiia = Angiology and vascular surgery","volume":"32 1","pages":"104-112"},"PeriodicalIF":0.0,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148248714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}