Affiliation:
1. Vishnevsky National Medical Research Center of Surgery, Federal State Budgetary Institution of the Ministry of Health
Abstract
This article presents a clinical observation of a patient with a giant atherosclerotic abdominal aortic aneurysm and comorbid uncorrected coronary artery disease. Taking into account the threat of aneurysm rupture, we have chosena surgical intervention using methods that reduce the risk of cardiovascular events in the perioperative period: the distal-first technique allowed us to reduce the aortic clamping time, and the use of temporary axillofemoral bypass grafting reduced peripheral resistance and stress on myocardium.
Reference7 articles.
1. Brewster D.C., Cronnenwett J., Hallett J.W. Jr et al. Guidelines for the treatment of abdominal aortic aneurisms. Report of a subcommittee of the Joint Council of the American Association for Vascular Surgery and Society for Vascular Surgery. J Vasc Surg. 2003;37:1106-1117.
2. Conway K.P., Byrne J., Townsend M., Lane I.F. Prognosis of patients turned down for conventional abdominal aortic aneurysm repair in the endovascular and sonographic era: Szilagyi revisited? J Vasc Surg. 2001;33:752-757.
3. Lederle F.A., Johnson G.R., Wilson S.E., Ballard D.J., Jordan W.D., Blebea J. et al. Rupture rate of large abdominal aortic aneurysms in patients refusing or unfit for elective repair. JAMA. 2002;72:287-296.
4. Laine M.T., Vanttinen T., Kantonen I. et al. Rupture of Abdominal Aortic Aneurysms in Patients Under Screening Age and Elective Repair Threshold. Eur J Vasc Endovasc Surg. 2016;1-6.
5. Skibba A.A., Evans J.R., Hopkins S.P., et al. Reconsidering Gender Relative to Risk of Rupture in the Contemporary Management of Abdominal Aortic Aneurysms. J Vasc Surg. 2015;62:1429-36.