CC BY
21
ОБЩАЯ И ЧАСТНАЯ ХИРУРГИЯ
doi: 10.18484/2305-0047.2021.5.535
E.L. KALMYKOV S W. AHMAD S I.A. SUCHKOV 2, R.E. KALININ 2, O. NEMATZODA 3, A.D. GAIBOV 4, D.D. SULTANOV 4, P. MAJD 4, J. BRUNKWALL 1
DEMOGRAPHICS OF PATIENTS WITH ABDOMINAL AORTIC ANEURYSM IN 3 DIFFERENT COUNTRIES: GERMANY, TAJIKISTAN AND RUSSIA
Cologne University Clinic *, Cologne,
Germany,
I.P. Pavlov Ryazan State Medical University 2, Ryazan,
Russian Federation,
Republican Scientific Center for Cardiovascular Surgery of the Ministry of Health and Social Protection of the Population 3, Dushanbe,
Avicenna Tajik State Medical University 4, Dushanbe,
Republic of Tajikistan
Цель. Сравнить демографические характеристики, сопутствующие заболевания и факторы риска у пациентов с аневризмой брюшной аорты (АБА), получавших лечение в трех странах: Германия, Таджикистан и Россия.
Материал и методы. Было проведено ретроспективное сравнительное исследование с участием пациентов с инфраренальной аневризмой брюшной аорты, которые лечились либо с помощью эндоваскулярного протезирования, либо с помощью открытого протезирования аневризмы брюшной аорты в период с 2011 по 2015 год в Кельне, Душанбе и Рязани. В исследование были включены 711 пациентов: 499 из Кельна, 46 из Душанбе и 166 из Рязани. Ретроспективно были собраны демографические данные, включавшие возраст, пол, индекс массы тела, сопутствующие заболевания (диабет, ишемическая болезнь сердца, гипертония, цереброваскулярные заболевания, ХОБЛ, курение), фактическое лечение, а также диаметр брюшной аорты.
Результаты. Статистически значимой разницы в распространенности аневризмы брюшного отдела аорты в зависимости от пола между исследовательскими центрами не было. Точно так же индекс массы тела существенно не отличался между 3 центрами. Однако пациенты из Кельна были старше, чем из Душанбе и Рязани. Количество пациентов с разрывом аневризмы брюшной аорты было значительно меньше в Кельне по сравнению с двумя другими учреждениями (p<0,05). Диаметр AБA у пациентов в Рязани и Душанбе был больше, чем в Кельне. Что касается лекарств, которые получали пациенты, то в Кельне значительно чаще применялись препараты, снижающие агрегацию тромбоцитов, статины и бета-блокаторы. Пациенты из Таджикистана страдали ХОБЛ чаще, чем пациенты из других центров.
Заключение. Распространенность сопутствующих заболеваний, факторы риска, а также лекарственная терапия у пациентов с аневризмой инфраренальной брюшной аорты различаются в разных географических регионах.
Ключевые слова: аневризма брюшной аорты, разрыв аневризмы, факторы риска, демографические различия, летальность, эндоваскулярное лечение
Objective. To compare the demographics, comorbidities and risk factors in patients with abdominal aortic aneurysm (AAA) treated in three different communities; Germany, Tajikistan and Russian Federation.
Methods. A retrospective comparative study including patients with an infrarenal AAA who were treated with either endovascular aneurysm repair (EVAR) or open repair (2011-2015) in Cologne, Dushanbe and Ryazan was done. A total number of 711 patients, 499 from Cologne, 46 from Dushanbe and 166 from Ryazan were included in the study. Demographic data including age, gender, body mass index (BMI), comorbidities (diabetes, coronary artery disease (CAD)), hypertension, cerebrovascular disease, chronic obstructive pulmonary disease (COPD, smoking), actual treatment as well as the diameter of the abdominal aorta were collected, retrospectively.
Results. There was no statistically significant difference in AAA prevalence with respect to gender between the study centers. Similarly, the BMI did not differ significantly between these 3 centers. Though, the patients from Cologne were older than those from Dushanbe and Ryazan. Moreover, the number of patients treated due to ruptured aneurysm was significantly lower in Cologne in comparison to the other two centers (P<0.05). The AAA-diameter of patients in Ryazan and Dushanbe was greater than that found in Cologne. Regarding the actual medication that patients were presented with, antiplatelet-aggregation medication, statin and beta blockers were used significantly more often in Cologne. Patients from Tajikistan had COPD more often than patients from the other centers.
Conclusion. The prevalence of comorbidities, risk factors as well as medication in patients with infrarenal abdominal aortic aneurysm is different in the various geographical regions.
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© E.L. Kalmykov et al. Demographic differences in patients with aortic aneurism
Keywords: abdominal aortic aneurysm, ruptured aneurysm, risk factors, demographic differences, mortality, endovascular treatment
Novosti Khirurgii. 2021 Oct-Nov; Vol 29 (5): 535-541 The articles published under CC BYNC-ND license
Demographic Differences in Patients with Abdominal Aortic Aneurysm in 3 Different Countries:
Germany, Tajikistan and Russian Federation b-h.ih!M'.i
E.L. Kalmykov, W. Ahmad, I.A. Suchkov, R.E. Kalinin,
O. Nematzoda, A.D. Gaibov, D.D. Sultanov, P. Majd, J. Brunkwall
Научная новизна статьи
исследование демонстрирует, что распространенность сопутствующих заболеваний, факторы риска, а также лекарственная терапия у пациентов с аневризмой инфраренальной брюшной аорты различаются в разных географических регионах. впервые эти различия были продемонстрированы у пациентов из российской Федерации и таджикистана.
What this paper adds
The study demonstrates that the prevalence of comorbidities, risk factors as well as medication in patients with infrarenal abdominal aortic aneurysm is different in the various geographical regions. These differences have been firstly demonstrated in patients from the Russian Federation and Tajikistan.
Introduction
Abdominal aortic aneurysm (AAA) is a common and potentially life-threatening disease, with a high mortality due to rupture [1,2]. AAA is multifactorial and most patients have comorbidities that may significantly influence the postoperative results and survival rate after elective or emergency treatment [3]. In addition, some comorbidity may also increase the progression of AAA [4]. A number of studies have demonstrated that cardiovascular and pulmonary diseases increase morbidity and mortality after open or endovascular repair in patients with AAA [3,5,6]. The development of minimally invasive endovascular technologies has decreased the number of postoperative complications within 30 days as well as the mortality, especially in the group of patients with severe comorbidity and high operative risk [6].
In recent years, a couple of studies have published data about differences in the structures of comorbidities and risk factors in patients with AAA, but almost all these were restricted to patients from either the European Union, USA or East Asia [3,7-10]. No studies have been published on the risk factors in patients from Tajikistan and there are very few English-language publications from Russia. As far as we know today there are no publications comparing demographics, comorbidities, and risk factors in patients from different geographical regions.
Objective. To compare the demographics, comorbidity and risk factors in patients with abdominal aortic aneurysm (AAA) treated in three different countries - Cologne (Germany), Dushanbe (Tajikistan) and Ryazan (Russian Federation).
Methods
A retrospective comparative study of patients with an infrarenal AAA treated with either EVAR or
open repair (2011-2015) in the University Hospital of Cologne, Germany, I.P. Pavlov Ryazan State Medical University, Ryazan, Russian Federation and the National Center for Cardiovascular Surgery, Dushanbe, Tajikistan has been conducted.
Cologne University Hospital is the largest hospital in Cologne, with approximately 1,500 beds, 63,200 patients in inpatient department and approximately 312.500 outpatients as of 2017.
Ryazan Regional Cardiology Clinic is the largest hospital in the Ryazan region with 60 beds and about 2.200 patients per year. The National Center for Cardiovascular Surgery in Dushanbe is the main medical center in the Republic and treats patients with vascular pathology from three different regions of the country. The clinic has a capacity of 120 beds and cares about 5.100 patients per year.
The study included 711 patients, 499 - from Cologne, 46 - from Dushanbe and 166 - from Ryazan. Epidemiological data, including age, gender and body mass index (BMI), with such comorbidities as diabetes, coronary artery disease (CAD), hypertension (defined as the presence of a systolic component >140mmHg and diastolic >90mmHg), cerebrovascular disease, (COPD), smoking, current medication as well as the diameter of the abdominal aorta were studied, retrospectively.
Due to the retrospective nature of the present study, no additional approval from the Ethics Commissions was required. written informed consent was obtained prior to each procedure.
Statistics
The statistical analyses were performed by using SPSS 25 statistical software (IBM SPSS Statistics Version 25.0.0.0, 2017). A test on normality was performed for all numeric data before the statistical comparison. Data are reported as median and interquartile ranges (IQRs) for continuous variables and as percentages for nominal variables.
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© Новости хирургии Том 29 * № 5 * 2021
For statistical comparisons of non-parametric data, the Kruskal-Wallis test for independent samples was used and the Mann-whitney test, whereas the t-test was used for the statistical analysis of parametric data. To compare categorical variables a square test was used. A Bonferroni Test as a type of multiple comparison test used on a significance level. The value of p <0.05 was considered to be statistically significant.
Results
Details of demographics, comorbidities, patients’ medication, and clinical data are presented in the table. Male-to-female ratios and BMI were nearly the same at these three centers. However, the patients from Cologne were older than those from Dushanbe and Ryazan.
By comparing the comorbidities in these three centers, the rates of diabetes, CAD, hypertension and COPD were greater in Dushanbe than in Cologne. During the same time, the rates of CAD and hypertension were greater in Ryazan than in Cologne.
The prescription rate of “vascular medication” such as ft-blockers, statins and aspirin were highest in Cologne and lowest in Dushanbe.
The AAA diameter was somewhat greater in patients from Ryazan and Dushanbe than from Cologne and this was reflected both in the frequency of patients with ruptured aneurysm (rAAA) and in the 30-day mortality. The findings for Ryazan and Dushanbe were very similar regarding this end-point.
The performed comparative analysis showed that the frequency of lethal outcomes associated with aneurysm ruptures was significantly higher in patients in Ryazan and Dushanbe (28 (57%) and 8 (61%), respectively) compared to Cologne 11 (22%)) with P<0.001. Moreover, the 30-day mortality was the highest in Dushanbe (2 (6%)), than in Ryazan (2 (1.7%)) and Cologne (9 (2%)); although without a statistically significant difference.
Discussion
AAA is to date one of the commonest and most life threatening diseases, with extremely high mortality when rupture occurs. We compared the findings from three centers — Cologne (Germany), Ryazan (Russian Federation) and Dushanbe (Tajikistan, Central Asia).
In our study, the largest number of patients with abdominal aortic aneurysms was in Cologne (Germany) and the least in Dushanbe (Tajikistan, Central Asia). 30-day mortality after an elective operation was similar in all three centers, but the lethal outcomes due to rupture was significantly
higher in Ryazan and Dushanbe. This fact in our opinion may be a result of more frequent application of screening program in Cologne [11]. As well as the known higher incidence of AAA in the western world as compared to the developing countries including Asian countries [6, 12]. On the other hand, the prevalence of AAA is much lower in Latin America and Central Asia [4,6]. The use of the term “Asian population” causes some confusion, since the Asian region is populated by significantly different ethnic groups, it does not allow adopting the results of the Asian region to another, in particular, regarding the aortic aneurysm
These differences may be due to differences in patients’ care, to differences in comorbidities and smoking or perhaps due to inherent differences in patient populations.
Patients’ care:
Since patients undergo a wider screening program in Germany, it is more probable that aneurysms would be detected. In Ryazan and Dushanbe no screening programs — partially because of the distance between settlements, but exacerbated by social and financial factors and low adherence to treatment [4]. Potentially, the diameter of the aortic aneurysm and the frequency of rAAA were significantly lower in patients from Cologne than in those from Ryazan and Dushanbe.
Another factor that might have played a favorable role regarding the perioperative mortality in Cologne may be the frequent use of endovascular surgery in comparison to Russian Federation and Tajikistan where rAAAs were treated with open repair.
Comorbidities and Smoking:
The association between AAA and smoking is fairly well known [13]. There is also an indirect association between smoking and the development of an aneurysm, via CAD and COPD.
According to Kuhnl A et al. [14], the most common comorbidities of AAA in Germany are hypertension, CAD and PAD. In our study, we found CAD and hypertension to be common comorbidities.
In Tajikistan and the Russian Federation the number of patients with CAD and hypertension were significantly greater than that in Cologne.
In our study, the number of smokers was significantly lower in Ryazan than this in Cologne and Dushanbe.
The highest rate of COPD was in patients in Dushanbe, and the lowest in Cologne. A metaanalysis by Jiang Xiong et al. [5] demonstrated that AAA mortality is higher among COPD patients than non-COPD patients, and that COPD can increase the postoperative mortality in group of patients with rAAA. Moreover, long-term mortality was greater with more severe COPD.
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Table
Baseline characteristics of the incidence of comorbidities and drug therapy_______________
Parameters Cologne, Germany Dushanbe, Tajikistan Ryazan, Russian Federation p-value
sex: female male 346 (69,3%) 153 (30,7%) 33 (72%) 13 (28%) 130 (78,3%) 36 (21,7%) p=0.085
Age) (years) (Me[Q1-Q3]) 73 [67-79] 65 [63-68] 68 [62-76] *p<0.001 **p<0.001 ***p=0.036
Height (м)(Ме [Q1-Q3]) 1,75 [1,70-1,80] 1,72 [1,68-1,76] 1,72 [1,68-1,76] *p=0.014 **p<0.001 ***p=0.974
BMI (body mass index)(Me [Q1-Q3]) 26.3 [23,9-29,3] 25.7 [24,6-27,9] 26 [24,2-28,7] p=0.585
Diameter of AAA (шш)(Ме [Q1-Q3]) 54 [50-61] 58 [54-63] 60 [48-75] *p=0.003 **p<0.001 ***p=0.744
Aneurism rupture 50 (10%) 13 (28,2%) 49 (29,5%) *p=0.001 **p<0.001 ***p=0.513
Diabetes 85 (17%) 11 (24%) 10 (6,2%) *p=0.311 **p<0.001 *** p=0.001
CAD 119 (24%) 28 (61%) 129 (77%) *p<0.001 **p<0.001 *** p=0.035
Hypertension 341 (68%) 44 (95%) 133 (80,1%) *p<0.001 **p=0.019 *** p=0.012
Smoking 163 (33%) 15 (33%) 32 (19%) *p=0.554 **p<0.001 *** p=0.045
COPD 92 (18,4%) 18 (39%) 33 (20 %) *p=0.002 **p=0.733 *** p=0.011
Я-blockers 290 (58,1) 12 (26%) 31 (18,6%) *p<0.001 **p=0.163 *** p=0.175
Statins 282 (56,5%) 14 (30%) 70 (42%) *p<0.001 **p<0.001 ***p=0.175
Aspirin 335 (67%) 14 (30%) 87 (52%) *p<0.001
**p<0.001
***p=0.012
* — Comparison between Cologne and Dushanbe; ** — Comparison between Cologne and Ryazan; *** — Comparison between Dushanbe and Ryazan.
Takagi H et al. [15] demonstrated a statistically significant association of CAD with slower AAA growth rates, but Elkalioubie A. et al. [16] found that AAA prevalence in patients was 8.4% was higher in patients with CAD versus subjects without CAD.
Diabetes may be protective against AAA, possi-
bly due to an effect of metformin [13]. In our study, the incidence of diabetes was significantly different in patients from these three different countries, with the largest number of patients from Tajikistan.
we have not obtained statistically significant differences in BMI between the three centres. The
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role and significance of this factor in AAA progression is debatable. Stackelber O. et al. [17] demonstrated the waist circumference but not BMI was associated with risk of AAA incidence.
Patients’ Populations:
Since it is well known that there is a genetic component in susceptibility to AAA, it is highly plausible that there are genuine differences between different population cohorts [4]. However, it is practically almost impossible to identify these patients from the whole population and to provide them a special screening program for AAA.
Conclusion
Clinical outcomes, rates of comorbidities, risk factors as well as medication in patients with infrarenal abdominal aortic aneurysm are different in the various geographical regions. These differences may be associated with differences in patients’ care, comorbidities or in the genetics of the different populations.
Financing
The research was carried out without any financial assistance.
Conflict of interests
The authors declare no conflicts of interest.
ЛИТЕРАТУРА
1. Gawenda M, Brunkwall J. Ruptured abdominal aortic aneurysm: the state of play. Dtsch Arztebl Int. 2012 Oct;109(43):727-32. doi: 10.3238/arztebl.2012.0727
2. Hoornweg LL, Storm-Versloot MN, Ubbink DT, Koelemay MJ, Legemate DA, Balm R. Meta analysis on mortality of ruptured abdominal aortic aneurysms. Eur J Vasc Endovasc Surg. 2008 May;35(5):558-70. doi: 10.1016/j.ejvs.2007.11.019
3. Vanni V, Turtiainen J, Hakala T, Salenius J, Suominen V, Oksala N, Hernesniemi J. Vascular comorbidities and demographics of patients with ruptured abdominal aortic aneurysms. Surgery. 2016 Apr;159(4):1191-98. doi: 10.1016/j.surg.2015.10.005
4. Sakalihasan N, Michel JB, Katsargyris A, Kuivaniemi H, Defraigne JO, Nchimi A, Powell JT, Yoshimura K, Hultgren R. Abdominal aortic aneurysms. Nat Rev Dis Primers. 2018 Oct 18;4(1):34. doi: 10.1038/s41572-018-0030-7. Review.
5. Xiong J, Wu Z, Chen C, Guo W. Chronic obstructive pulmonary disease effect on the prevalence and postoperative outcome of abdominal aortic aneurysms: A meta-analysis. Sci Rep. 2016 Apr 26;6:25003. doi: 10.1038/srep25003
6. Wanhainen A, Verzini F, Van Herzeele I, Allaire E, Bown M, Cohnert T, Dick F, van Herwaarden J, Karkos C, Koelemay M, Kolbel T, Loftus I, Mani K, Melissano G, Powell J, Szeberin Z, Esvs Guidelines Committee, de Borst GJ, Chakfe N, Debus S, ffinchliffe
R, Kakkos S, Koncar I, Kolh P, Lindholt JS, de Vega M, Vermassen F, Document Reviewers, Bjorck M, Cheng S, Dalman R, Davidovic L, Donas K, Earnshaw J, Eckstein HH, Golledge J, Haulon S, Mastracci T, Naylor R, Ricco JB, Verhagen H. Editor's Choice — European Society for Vascular Surgery (ESVS) 2019 Clinical Practice Guidelines on the Management of Abdominal Aorto-iliac Artery Aneurysms. Eur J Vasc Endovasc Surg. 2019 Jan;57(1):8-93. doi: 10.1016/j. ejvs.2018.09.020
7. Budtz-Lilly J, Venermo M, Debus S, Behrendt CA, Altreuther M, Beiles B, Szeberin Z, Eldrup N, Danielsson G, Thomson I, Wigger P, Bjorck M, Loftus I, Mani K. Editor's Choice - Assessment of International Outcomes of Intact Abdominal Aortic Aneurysm Repair over 9 Years. Eur J Vasc Endovasc Surg. 2017 Jul;54(1):13-20. doi: 10.1016/j.ejvs.2017.03.003
8. Tang W, Yao L, Roetker NS, Alonso A, Lutsey PL, Steenson CC, Lederle FA, Hunter DW, Bengtson LG, Guan W, Missov E, Folsom AR. Lifetime Risk and Risk Factors for Abdominal Aortic Aneurysm in a 24-Year Prospective Study: The ARIC Study (Atherosclerosis Risk in Communities). Arterioscler Thromb Vasc Biol. 2016 Dec;36(12):2468-77. doi: 10.1161/ATVBAHA.116.308147
9. Kent KC, Zwolak RM, Egorova NN, Riles TS, Manganaro A, Moskowitz AJ, Gelijns AC, Greco G. Analysis of risk factors for abdominal aortic aneurysm in a cohort of more than 3 million individuals. J Vasc Surg. 2010 Sep;52(3):539-48. doi: 10.1016/j. jvs.2010.05.090
10. Wang SW, Huang YB, Huang JW, Chiu CC,
Lai WT, Chen CY. Epidemiology, Clinical Features, and Prescribing Patterns of Aortic Aneurysm in Asian Population From 2005 to 2011. Medicine (Baltimore). 2015 Oct;94(41):e1716. doi: 10.1097/
MD.0000000000001716
11. Heidemann F, Meier U, Kolbel T, Atlihan G,
Debus ES. How can an AAA screening program be implemented in Germany? Gefasschirurgie. 2015;
20(Suppl 1):28-31. doi: 10.1007/s00772-014-1392-0
12. Li X, Zhao G, Zhang J, Duan Z, Xin S. Prevalence and trends of the abdominal aortic aneurysms epidemic in general population — a meta-analysis. PLoS One. 2013 Dec 2;8(12):e81260. doi: 10.1371/journal. pone.0081260. eCollection 2013.
13. Aune D, Schlesinger S, Norat T, Riboli E. Diabetes mellitus and the risk of abdominal aortic aneurysm: A systematic review and meta-analysis of prospective studies. J Diabetes Complications. 2018 Dec;32(12):1169-74. doi: 10.1016/j.jdiacomp.2018.09.009
14. Kuhnl A, Erk A, Trenner M, Salvermoser M, Schmid V, Eckstein HH. Incidence, treatment and mortality in patients with abdominal aortic aneurysms. Dtsch Arztebl Int. 2017 Jun 5;114(22-23):391-98. doi: 10.3238/arztebl.2017.0391
15. Takagi H, Umemoto T; ALICE (All-Literature
Investigation of Cardiovascular Evidence) Group. Coronary artery disease and abdominal aortic aneurysm growth. Vasc Med. 2016 Jun;21(3):199-208. doi:
10.1177/1358863X15624026
16. Elkalioubie A, Haulon S, Duhamel A, Rosa M, Rauch A, Staels B, Susen S, Van Belle E, Dupont A. Meta-analysis of abdominal aortic aneurysm in patients with coronary artery disease. Am J Cardiol. 2015 Nov 1;116(9):1451-56. doi: 10.1016/j.amjcard.2015.07.074
17. Stackelberg O, Bjorck M, Sadr-Azodi O, Larsson SC, Orsini N, Wolk A. Obesity and abdominal aortic
539
© E.L. Kalmykov et al. Demographic differences in patients with aortic aneurism
aneurysm. Br J Surg. 2013 Feb;100(3):360-66. doi: 10.1002/bjs.8983
REFERENCES
1. Gawenda M, Brunkwall J. Ruptured abdominal aortic aneurysm: the state of play. Dtsch Arztebl Int. 2012 Oct;109(43):727-32. doi: 10.3238/arztebl.2012.0727
2. Hoornweg LL, Storm-Versloot MN, Ubbink DT, Koelemay MJ, Legemate DA, Balm R. Meta analysis on mortality of ruptured abdominal aortic aneurysms. Eur J Vasc Endovasc Surg. 2008 May;35(5):558-70. doi: 10.1016/j.ejvs.2007.11.019
3. Vanni V, Turtiainen J, Hakala T, Salenius J, Suominen V, Oksala N, Hernesniemi J. Vascular comorbidities and demographics of patients with ruptured abdominal aortic aneurysms. Surgery. 2016 Apr;159(4):1191-98. doi: 10.1016/j.surg.2015.10.005
4. Sakalihasan N, Michel JB, Katsargyris A, Kuivaniemi
H, Defraigne JO, Nchimi A, Powell JT, Yoshimura K, Hultgren R. Abdominal aortic aneurysms. Nat Rev Dis Primers. 2018 Oct 18;4(1):34. doi: 10.1038/s41572-018-0030-7. Review.
5. Xiong J, Wu Z, Chen C, Guo W. Chronic obstructive pulmonary disease effect on the prevalence and postoperative outcome of abdominal aortic aneurysms: A meta-analysis. Sci Rep. 2016 Apr 26;6:25003. doi: 10.1038/srep25003
6. wanhainen A, Verzini F, Van Herzeele I, Allaire E, Bown M, Cohnert T, Dick F, van Herwaarden J, Karkos C, Koelemay M, Kolbel T, Loftus I, Mani K, Melissano G, Powell J, Szeberin Z, Esvs Guidelines Committee, de Borst GJ, Chakfe N, Debus S, Hinchliffe R, Kakkos S, Koncar I, Kolh P, Lindholt JS, de Vega M, Vermassen F, Document Reviewers, Bjorck M, Cheng S, Dalman R, Davidovic L, Donas K, Earnshaw J, Eckstein HH, Golledge J, Haulon S, Mastracci T, Naylor R, Ricco JB, Verhagen H. Editor's Choice — European Society for Vascular Surgery (ESVS) 2019 Clinical Practice Guidelines on the Management of Abdominal Aorto-iliac Artery Aneurysms. Eur J Vasc Endovasc Surg. 2019 Jan;57(1):8-93. doi: 10.1016/j. ejvs.2018.09.020
7. Budtz-Lilly J, Venermo M, Debus S, Behrendt CA, Altreuther M, Beiles B, Szeberin Z, Eldrup N, Danielsson G, Thomson I, Wigger P, Bjorck M, Loftus
I, Mani K. Editor's Choice - Assessment of International Outcomes of Intact Abdominal Aortic Aneurysm Repair over 9 Years. Eur J Vasc Endovasc Surg. 2017 Jul;54(1):13-20. doi: 10.1016/j.ejvs.2017.03.003
8. Tang w, Yao L, Roetker NS, Alonso A, Lutsey PL, Steenson CC, Lederle FA, Hunter Dw, Bengtson
Адрес для корреспонденции
Клиника сосудистой и эндоваскулярной хирургии,
Университетская клиника города Кельн,
Kerpener Street 62, 50937 Кельн, Германия e-mail: egan0428@mail.ru,
Калмыков Еган Леонидович
Сведения об авторах
Калмыков Еган Леонидович, к.м.н., сосудистый хирург, Клиника сосудистой и эндоваскулярной хирургии, Клиника Кельнского университета,
LG, Guan W, Missov E, Folsom AR. Lifetime Risk and Risk Factors for Abdominal Aortic Aneurysm in a 24-Year Prospective Study: The ARIC Study (Atherosclerosis Risk in Communities). Arterioscler Thromb Vasc Biol. 2016 Dec;36(12):2468-77. doi: 10.1161/ATVBAHA.116.308147
9. Kent KC, Zwolak RM, Egorova NN, Riles TS, Manganaro A, Moskowitz AJ, Gelijns AC, Greco G. Analysis of risk factors for abdominal aortic aneurysm in a cohort of more than 3 million individuals. J Vasc Surg. 2010 Sep;52(3):539-48. doi: 10.1016/j. jvs.2010.05.090
10. Wang SW, Huang YB, Huang JW, Chiu
CC, Lai WT, Chen CY. Epidemiology, Clinical Features, and Prescribing Patterns of Aortic Aneurysm in Asian Population From 2005 to 2011. Medicine (Baltimore). 2015 Oct;94(41):e1716. doi: 10.1097/
MD.0000000000001716
11. Heidemann F, Meier U, Kolbel T, Atlihan
G, Debus ES. How can an AAA screening program be implemented in Germany? Gefasschirurgie.
2015;20(Suppl 1):28-31. doi: 10.1007/s00772-014-
1392-0
12. Li X, Zhao G, Zhang J, Duan Z, Xin S. Prevalence and trends of the abdominal aortic aneurysms epidemic in general population — a meta-analysis. PLoS One. 2013 Dec 2;8(12):e81260. doi: 10.1371/journal. pone.0081260. eCollection 2013
13. Aune D, Schlesinger S, Norat T, Riboli E. Diabetes mellitus and the risk of abdominal aortic aneurysm: A systematic review and meta-analysis of prospective studies. J Diabetes Complications. 2018 Dec;32(12):1169-74. doi: 10.1016/j.jdiacomp.2018.09.009
14. Kuhnl A, Erk A, Trenner M, Salvermoser M, Schmid V, Eckstein HH. Incidence, treatment and mortality in patients with abdominal aortic aneurysms. Dtsch Arztebl Int. 2017 Jun 5;114(22-23):391-98. doi: 10.3238/arztebl.2017.0391
15. Takagi H, Umemoto T; ALICE (All-Literature
Investigation of Cardiovascular Evidence) Group. Coronary artery disease and abdominal aortic aneurysm growth. Vasc Med. 2016 Jun;21(3):199-208. doi:
10.1177/1358863X15624026
16. Elkalioubie A, Haulon S, Duhamel A, Rosa M, Rauch A, Staels B, Susen S, Van Belle E, Dupont A. Meta-analysis of abdominal aortic aneurysm in patients with coronary artery disease. Am J Cardiol. 2015 Nov 1;116(9):1451-56. doi: 10.1016/j.amjcard.2015.07.074
17. Stackelberg O, Bjorck M, Sadr-Azodi O, Larsson SC, Orsini N, Wolk A. Obesity and abdominal aortic aneurysm. Br J Surg. 2013 Feb;100(3):360-66. doi: 10.1002/bjs.8983
Address for correspondence
Clinic of Vascular and Endovascular Surgery,
Helios University Clinic.
Wuppertal, Germany.
Heusener Street 40, 42283, Wuppertal e-mail: egan0428@mail.ru Kalmykov Egan L.
Information about the authors
Kalmykov Egan L., PhD, Vascular Surgeon, Clinic of Vascular and Endovascular Surgery, Cologne University Clinic, Cologne, Germany.
540
© Новости хирургии Том 29 * № 5 * 2021
Кельн, Германия.
https://orcid.org/0000-0001-6784-2243 Ahmad Wael, доктор медицины, клиника сосудистой и эндоваскулярной хирургии, Университетская клиника города Кельн, г. Кельн, Германия. https://orcid.org/0000-0001-5090-3468 Сучков Игорь Александрович, д.м.н., профессор, проректор по научной работе и инновационному развитию, профессор кафедры сердечно-сосудистой, рентгенэндоваскулярной, оперативной хирургии и топографической анатомии, Рязанский государственный медицинский университет имени академика И.П. Павлова, г. Рязань, Российская Федерация.
https://orcid.org/0000-0002-1292-5452 Калинин Роман Евгеньевич, д.м.н., профессор, ректор, заведующий кафедрой сердечно-сосудистой, рентгенэндоваскулярной, оперативной хирургии и топографической анатомии, Рязанский государственный медицинский университет имени академика И.П. Павлова, г. Рязань, Российская Федерация.
https://orcid.org/0000-0002-0817-9573 Нематзода Окилджон, к.м.н., ведущий научный сотрудник, Республиканский научный центр сердечно-сосудистой хирургии Министерства Здравоохранения и Социальной Защиты Населения,
г. Душанбе, Республика Таджикистан. https://orcid.org/0000-0001-7602-7611.
Гаибов Алиджон Джураевич, член-корр. АМН РТ,
д. м.н., профессор, профессор кафедры хирургических болезней № 2, Таджикский государственный медицинский университет им. Абуали ибни Сино; Республиканский научный центр сердечно-сосудистой хирургии, г. Душанбе, Республика Таджикистан.
https://orcid.org/ 0000-0002-7767-2556 Султанов Джавли Давронович, д.м.н., профессор, профессор кафедры хирургических болезней № 2, Таджикский государственный медицинский университет им. Абуали ибни Сино, г. Душанбе, Республика Таджикистан. https://orcid.org/0000-0001-7935-7763 Majd Payman, доктор медицины, клиника сосудистой и эндоваскулярной хирургии, Университетская клиника города Кельн, г. Кельн, Германия. https://orcid.org/0000-0002-5835-8318 Brunkwall Jan, профессор, клиника сосудистой и эндоваскулярной хирургии, Университетская клиника города Кельн, г. Кельн, Германия. https://orcid.org/0000-0003-3082-6009
Информация о статье
Поступила 20 октября 2020 г.
Принята в печать 6сентября 2021 г.
Доступна на сайте 1 ноября 2021 г.
https://orcid.org/0000-0001-6784-2243
Ahmad Wael, Doctor of Medicine, Department of
Vascular and Endovascular Surgery, University Clinics,
University of Cologne, Cologne, Germany.
https://orcid.org/0000-0001-5090-3468
Suchkov Igor A., MD, Professor, Vice-Rector for
Research and Innovative Development, Professor of
the Department of Cardiovascular, X-ray Endovascular,
Operatives and Topographic Anatomy, I.P. Pavlov
Ryazan State Medical University, Ryazan, Russian
Federation
https://orcid.org/0000-0002-1292-5452 Kalinin Roman E., MD, Professor, Rector, Head of the Department of Cardiovascular, X-ray Endovascular, Operatives and Topographic Anatomy, I.P. Pavlov Ryazan State Medical University, Ryazan, Russian Federation
https://orcid.org/0000-0002-0817-9573 Nematzoda Okildzhon, PhD, Leading Researcher, Republican Scientific Center for Cardiovascular Surgery of the Ministry of Health and Social Protection of the Population, Dushanbe, Republic of Tajikistan. https://orcid.org/0000-0001-7602-7611.
Gaibov Alidzhon D., Corresponding Member of AMS of RT, MD, Professor of the Department of Surgical Diseases No2, Avicenna Tajik State Medical University, Republican Scientific Center for Cardiovascular Surgery of the Ministry of Health and Social Protection of the Population, Dushanbe, Republic of Tajikistan. https://orcid.org/0000-0002-7767-2556 Sultanov Dzhavili D., MD, Professor of the Department of Surgical Diseases No2, Avicenna Tajik State Medical University Dushanbe, Republic of Tajikistan. https://orcid.org/0000-0001-7935-7763 Majd Payman, Doctor of medicine, Clinic of Vascular and Endovascular Surgery, Cologne University Clinic, Cologne, Germany. https://orcid.org/0000-0002-5835-8318 Brunkwall Jan, Professor, Clinic of Vascular and Endovascular Surgery, Cologne University Clinic, Cologne, Germany. https://orcid.org/0000-0003-3082-6009
Article history
Arrived: 20 October2020
Accepted for publication: 6 September 2021
Available online: 1 November 2021
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