CC BY
15
II. ХИРУРГИЯ
PREVENTIVE "BEFORE AND AFTER" SURGICAL TREATMENT OF AORTIC ANEURYSMS AND PERIPHERAL ARTERIES. LITERATURE REVIEW
Yegemberdiyev T.Zh.2, Baubekov A.A.12, Matkherimov A.Zh.1, Tergeusizov A.S.1, Zhakubaev M.A.12, Shamshiev A.S.1, Tadjibaev T.K.1
National Scientific Centre of Surgery named after A.N. Syzganov1
Kazakh National Medical University named after S.D. Asfendiyarov, Almaty, Kazakhstan2
Abstract
The article provides an overview of the literature data containing information about aortic and peripheral artery aneurysms. The emphasis is shifted towards preventive measures carried out in the provision of medical care to such patients. Preventive measures are considered «before» and «after» operational intervention. This division was made not from the standpoint of comparative analysis, but in order to determine the congruence significance of these concepts.
Перифериялык артериялар жане колка аневримасын хиругиялык жолмен емдеуге «дейшп» жэне «одан кейшп» алдын алу. Эдеби шолу.
Егембердиев Т.Ж.2, Баубеков А.А.1,2, Маткеримов А.Ж.1,
ТергеуЫзов А.С.1, Жакубаев М.А.1,2, Шамшиев А.С.1, Таджибаев Т.К.1
А.Н. Сызганов атында™ Улттык гылыми хирургия орталь™1
С.Д. Асфендияров атында™ Казак Улттык медициналык университетi, Алматы, Казахстан2
кА&дата
Макалада перифериялык артериялар жане колка аневримасы туралы акпараттан эдеби шолу келт1р1лед1. Осындай наукастарра медициналык кемек керсету кез1нде алдын-алу шараларына баса назар аударылады.
Алдын-алу шаралары ота жасауга «дейшп» жэне «одан кей1нг1» устанымы бойынша карастырылады. Осылай белу салыстырмалы талдау устанымы уш\н емес, бул угымдардыц конгурентт.i мацыздылыгын алдын-алу аныктау максатында енд1р1лд1.
МРНТИ 76.29.30
ABOUT THE AUTHORS
Yegemberdiyev T.Zh. - professor, MD, the head of the cardiovascular surgery department of surgical diseases № 3 KazNMU named after S.D. Asfendiyarov;
Baubekov A.A. - (baubekovS 1@mail.ru, +77017300080), Phd doctoral student of Ka-zNMU named after. S.D. Asfendiyarov, a vascular surgeon of the Department of Angiosurgery of the JSC NSCS named after A.N. Syzganov;
Matkherimov A.Zh. - Head of the Department of Angiosurgery of the JSC NSCS named after A.N. Syzganov;
Tergeusizov A.S. - angiosurgeon of the JSC NSCS named after A.N. Syzganov;
Zhakubaev M.A. - angiosurgeon, PhD doctoral student of KazNMU named after S.D. Asfendi-yarov, a vascular surgeon of the Department of Angiosurgery of the JSC NSCS named after A.N. Syzganov;
Shamshiev A.S. - angiosurgeon of the JSC NSCS named after A.N. Syzganov;
Tadjibaev T.K. - angiosurgeon of the JSC NSCS named after A.N. Syzganov.
Keywords
prophylaxis, aneurysm, peripheral arteries, endovascular treatment of aneurysms, hybrid techniques, aortic prosthesis, review.
АВТОРЛАР ТУРАЛЫ
Егембердиев Т.Ж. - профессор, м.г.д., С.Д. Асфендияров атындагы Каз¥МУ № хирургиялык аурулар кафедрасыньщ журек-к&н тамырлары хирургиясы курсыныц мецгерушм; Баубеков А.А. - (baubekov81@mail.ru, +77017300080), С.Д. Асфендияров атындаы Каз¥МУ Phd докторанты, А.Н. Сызганов атындагы YFXO АК кан-тамырлар беммшесЩ ангиохирургы;
Маткеримов А.Ж. - А.Н. Сызганов атындагы YFXO АК кан-тамырлар беммшесЩ мммеерурш; Тергеусизов А.С. - А.Н. Сызганов аатындагы YFXO АК кан-тамырлар бeлiмшесЩ даргер-ананоио'рурп;
Жакубаев М.А. - С.Д. Асфендияров агындагы Каз¥МУ Phd докторанты, А.Н. СызFанов атындагы YFXO АК кан-тамырлар беммшесЩ ангиохирургы;
Шамшиев А.С. - А.Н. Сызганов агындагы YFXO АК кан-тамырлар бешшесЩ даргер-ангиохирурп;
Таджибаев Т.К. - А.Н. Сызганов аатындагы YFXO АК кан-тамырлар бешшесЩ даргер-ананоио'рурп.
Туйш сездер
алдын-алу, аневризма, перефериялык артериялар, аневризманы эндоваскулярлы емдеу, гибридт эдю, аортыны протездеу, шолу.
Превентивность «до и после» хирургического лечения аневризм аорты и периферических артерий. Обзор литературы.
Егембердиев Т.Ж.2, Баубеков А.А.1,2, Маткеримов А.Ж.1,
Тергеусизов А.С.1, Жакубаев М.А.1,2, Шамшиев А.С.1, Таджибаев Т.К.1
Национальный научный центр хирургии им. А.Н. Сызганова1
Казахский национальный медицинский университет им. С.Д. Асфендиярова, Алматы, Казахстан2
Анссотция
В статье приводится обзор литературных данных, содержащих информацию об аневризмах аорты и периферических артерий. Акцент смещен в сторону профилактических мероприятий, проводимых при оказании медицинской помощи таким пациентам. Превентивные меры рассматриваются с позиций «до» оперативного вмешательства и «после» него. Такое разделение было произведено не с позиций сравнительного анализа, а с целью предопределения конгруэнтной значимости этих понятий.
ОБ АВТОРАХ
Егембердиев Т.Ж. - профессор, д.м.н., зав.курсом сердечно-сосудистой хирургии кафедры хирургических болезней №3 КазНМУ им. С.Д. Асфендиярова; Баубеков А.А. - (baubekov81@mail.ru, +77017300080), PhD докторант КазНМУ им. С.Д. Асфендиярова, сосудистый хирург отделения ангиохирургии АО ННЦХ им. А.Н. Сызгзгова; Маткерямов А.Ж. - заведующий отделом ангиохирургии АО ННЦХ им. А.Н. Сызганова;
Тергеусизов А.С. - врач-ангиохирург АО ННЦХ им. А.Н. Сызганова;
Жакубаев М.А. - PhD докторант КазНМУ им С.Д. Асфендиярова, сосудистый хирург отделения ангиохирургии АО ННЦХ им. А.Н. Сызгзново;
Шамшяев А.С. - врач-ангиохирург АО ННЦХ им. А.Н. Сызганова;
Таджибаев Т.К. - врач-ангиохирург АО ННЦХ им. А.Н. Сызганова.
Ключевые слова
профилактика, аневризма, периферические артерии, эндо-васкулярное лечение аневризм, гибридные методики, протезирование аорты, обзор.
Aneurysms of the aorta and peripheral arteries are a common variant of the pathology of the cardiovascular system. According to the World Health Organization, cardiovascular diseases (CVD) are the leading causes of death worldwide (mortality is 17.7 million people per year). The main causes of CVD are atherosclerosis and chronic inflammation of the vascular wall. It is with these causes associated with the development of another common vascular disease - an aneurysm. According to statistical data of foreign authors, aneurysms of the abdominal aorta (AAA) affect from 2 to 8% of older people [1].
Publications of Russian scientists show that AAA occurs in 0.6-3.5% of deceased people in a sectional study and is 5-10 times more common in men than in women. After anemia diagnosis of an aneurysm, mortality occurs within 1-2 years in 50-60% of cases. A dangerous complication is the stratification of AAA, which occurs during autopsy of 0.1-2.2% of deaths [2].
Aneurysms of the popliteal artery (an increase in popliteal artery more than 50% of the original diameter) constitute the most common form of aneurysm of the peripheral vascular system with a control of 70-80%. In 50% of cases, the condition is bilateral, and up to 50% of cases can occur in connection with aneurysms of other large vessels (for example, the abdominal aorta) [3].
Aneurysms of the aorta and peripheral vessels are high, clinical prevention of aneurysms is difficult, since the disease often occurs asymptomatically and remains untreated before the vessel ruptures. At break, the total mortality is from 80% to 90% [1].
As the landscape of medical imaging and diagnosis changed dramatically with the discovery of X-rays by German physicist Wilhelm Conrad Roentgen in 1895, there was a constant search for better resolution and contrast images [4]. However, the results of the early day of an aneurysm are not reassuring, early detection is at a low level, and massive preventive measures, a refusal to prevent the development of aneurysms, do not have proper attention.
In addition, there remains a need to develop new therapeutic strategies to prevent the progression of aneurysms. Even with the timely and qualitatively performed emergency resection of the aneurysm of the abdominal aorta, the results remain unsatisfactory, which is associated with severe postoperative complications detected at a minimum in every second patient. All this determines the relevance of the ongoing research.
Already for almost seventy years, open surgical techniques are the main option for surgical intervention on the aorta. In comparison, the advantages and disadvantages of open and endovas-
cular methods are many adherents of this or that method. Now, however, increasingly in their debate, supporters prefer to come to interact, and offer hybrid techniques, all the more so that the common efforts are aimed at preserving the life and health of the patient. Hybrid techniques allow for reintervent intervention, if necessary. It was established that it is possible to reduce the incidence of complications and postoperative mortality in the provision of medical care in specialized vascular centers [5].
The indication for the transition to open surgery is an aneurysm of type I, type III, endolac type II and endotonium. The transition from endovascular technique to open surgery is often unpredictable [6]. The radical method of open surgery is resection of an aneurysm and replacement of a defect with an allograft [7].
American researchers from Texas conduct a comparative analysis of endovascular interventions and open surgery, the average loss of blood is 500 ml (300-700 ml) in the absence of pre-operative risk factors and 30-day mortality. In patients who underwent open interventions, the average blood loss was 800 ml (600-1200 ml), and they acquired the ability to move independently 4 days on average throughout the cohort (2-7 days), whereas for endovascular operations, these on average 2 days (1-3 days). During endovascular surgery of the postoperative period, it is more favorable than in patients undergoing open surgery [8-10].
It was revealed that the operation has more prognostically favorable characteristics. Furthermore, the volume rate with a surgical procedure scheduled endovascular technique can be limited, allowing to avoid open surgery [11].
In acute dissecting aortic aneurysm syndrome its transformation «shaggy aorta» and posttraumatic false aneurysm can be «frozen elephant trunk» with implantation of hybrid stent-graft «E-vita open plus» [12].
In addition, endovascular treatment can be applied in the treatment of aneurysms of the carotid artery bifurcation aneurysms, which often occur at a younger age. It is proved that this method of treatment is safe and acceptable [13-15].
However, percutaneous femoral vascular access is most often used in endovascular aortic surgery. If the patient has a calcified femoral artery, an operation is performed with open access or through the upper limbs (axillary artery) along the catheter-conductor. At the same time, many anatomical limitations arising from transfemoral access are overcome [9, 16]. In addition, access to the upper extremities significantly reduces the risk of stroke [16, 17].
Traditionally, when performing operations on the peripheral arteries of the lower limbs, open op-
tions of intervention are used [18, 19]. However, endovascular surgical techniques have become very popular with surgeons and patients, since modern stent designs have been used to replace those vessels that undergo physiological conditions of constant flexion-extensor deformation [18, 20].
Thus, surgical intervention on aneurysmally dilated vessels should be performed using preopera-tive diagnostic training, including instrumental examination, to determine the extent of intervention, access, stratification of operational risk.
Continuous postoperative observation is recommended after all types of aneurysm interventions. Although its goal is to prevent and / or identify early complications. In endoscopic interventions, the early postoperative period proceeds more safely [21].
Among all isolated early postoperative complications (death, dialysis) and late (myocardial ischemia, respiratory insufficiency, acute renal damage, chylothorax, disturbance of the spinal cord, neurological complications, hemorrhagic anemia, ischemic colitis left half of the colon, and others.). Severity of complications and their combination predetermine postoperative intensive therapy and length of stay of the patient in a hospital [2, 22-24].
Different outcomes of surgical intervention are mortality, repeated hospitalization, complications and others [25]. Stratification of postoperative risk should be carried out before the operation, and, taking into account the personified information about the variant anatomy of the vessels of a particular patient [26].
In the case of inflammatory etiology of aneurysms, including immune aneurysms [27, 28], giant cell arteritis associated with a permanent inflammatory syndrome of the entire aorta and brachiocephalic arteries can be a postoperative complication [29].
According to the literature, the 30-day mortality rate ranges from 8.5% to 30%, and mortality after 3 months after surgery - 44%. On mortality affects AAA rupture, preoperative shock, intraoperative cardiopulmonary resuscitation (CPR), the use of balloon occlusion of the aorta, intraoperative massive blood transfusion, the development of abdominal compartment syndrome, aortokovalnye fistulas, and other peripheral artery disease. However, the anamnestic information about the previous operation is related to favorable prognostic signs. Mortality in the performance of open operations is comparable to that of endovascular techniques [30-32].
Domestic scientists have developed a special evaluation scale of risk of exfoliating aortic aneu-rysm. This scale allows, at the pre-hospital stage, to help patients identify those clinical factors and symptoms that can lead to the disease [33].
The prevalence of spinal cord ischemia followed by paraplegia after endovascular surgery in the tho-
racic aorta and thoraco-abdominal segment is estimated at 2.5% and 8%. On average, paraplegia is detected in 4.2% of patients undergoing surgery for aneurysms. It is believed that the age, sex, urgency of the operation are independent risk factors for 30-day mortality [34].
Complications that occur in the area of access to vessels during endovascular interventions arise in 5% - 16% of cases [16]. It is known that the configuration of the stent does not lead to postoperative complications [35].
Preventative and preventive medical care for patients with aortic aneurysms that are susceptible to surgical treatment is based on the timely detection and prevention of complications and / or adverse consequences after surgery.
It has been established that the sex of the patient exerts a protective effect on the development of aneurysms. Thus, women are less prone to developing aneurysms due to the anti-inflammatory effect of estrogen. However, to ensure this effect, the presence of both ovaries and extragonadal / peripheral aromatase is necessary, which explains the increase in the frequency of aneurysms among age-related women [36].
The most susceptible to the development of aneurysms are men aged 65-75 years. Prophylactic prevention of aneurysm development in all patients, but especially in this group of patients, should be aimed at identifying additional risk factors: smoking, carotid artery disease or other peripheral vessels, overweight, hypertension and others [37].
In 2014, due to preventive services of the target group (AAA screening), the death rate of patients suffering from this disease has almost halved. Despite the simplicity of the study, studies show that there is poor adherence to the AAA screening guidelines [38]. This can strengthen and improve compliance with screening programs by creating an electronic medical system, in particular electronic medical records.
The increased use of AAA screening will lead to a significant increase in life expectancy. Expansion of screening also has potential for patients with aneurysms [40-44]. In an integrated health care system, using electronic medical records, screening can not be realized with a sharp reduction in patients [43].
A genetic risk factor for an aneurysm is the mutations in the genes TGFBR1 and TGFBR2, which were found in families, guardian members by one of the types of aneurysms: intracranial, abdominal or thoracic aorta [45]. Genetic analysis of family and sporadic cases of aortic aneurysm and its dissection, possibly, to aneurysm mortality due to early, preclinical diagnosis of genetically determined diseases among patients and their family members. All
this stimulates the adoption of new, more justified management decisions [46].
The risk of neurologic impairment in patients with distally located aneurysms of cerebral vessels is quite high [47]. To prevent some neurological disorders, for example, when performing operations on cerebral vessels, solutions of magnesium sulfate for irrigation of the wound [48]. You can also use auxiliary tools, for example NeuroForm Atlas Stent [49]. It is also justified to use selective drainage of cerebrospinal fluid in patients with high postoperative risk. It is necessary to avoid perioperative hypotension and treat when necessary. The use of moderate hypothermia is promising in small groups, but requires further evaluation [50].
The ultimate goal of preventive treatment is to improve the number of years of life with a high level of satisfaction with life. It was revealed that the satisfaction of life in the recovery period after the treatment of unexploded aneurysms. Number of fans, about one patient. These effects should be considered when considering an aneurysm [51].
[52, 53]. Correctly and correctly planned algorithm of medical care with aneurysms, associated
References
not only with the well-being of patients, but also with economic benefits for health [52, 53].
Perioperative prophylaxis of radiation load on the patient with endovascular operations on the aorta and peripheral femoral artery can be performed using modern technologies. And then the principle «as low as reasonably achievable» should act. This is especially important, since a decrease in radiation load predetermines the prospects, volume and complexity of endovascular and hybrid operations [54, 55].
Thus, high statistical rates of aneurysm prevalence among the population, surgical options and stratification of postoperative treatment require close attention in providing medical and preventive care to this group of patients. Preventive measures can be divided into subgroups «before surgery» and «after sur-gery.» The first group of measures aimed at preventing complications of an aneurysm, including a close clinical study aimed at identifying the risk of developing an aneurysm. Genetic history, bad habits, gender identity, the presence of concomitant diseases, etc. D. D. The second group of preventive measures aimed at alleviating perioperative complications.
1. van Puijvelde GHM, Foks AC, van Bochove RE, et al. CD1d deficiency inhibits the development of abdominal aortic aneurysms in LDL receptor deficient mice. PLoS One. 2018 Jan 18;13(1):e0190962.
2. Mosjagin V.B., Ryl'kov V.F., Moiseev A.A., i dr. Os-lozhnenija u bol'nyh posle rechenija razryva anevriz-my brjushnoj aorty v mnogoprofil'nom stacionare Angiologija i sosudistaja hirurgija. 2014. T. 20. № S2. S. 243-244.
3. Ghotbi R, Deilmann K. Popliteal artery aneurysm: surgical and endovascular therapy]. Chirurg. 2013 Mar;84(3):243-54.
4. Logghe G, Trachet B, Aslanidou L, et al. Propagation-based phase-contrast synchrotron imaging of aortic dissection in mice: from individual elastic lamella to 3D analysis. Sci Rep. 2018 Feb 2;8(1):2223.
5. Alfonsi J, Murana G, Smeenk HG, et al. Open surgical repair of post-dissection thoraco-abdominal aortic aneurysms: early and late outcomes of a single-centre study involving over 200 patients. Eur J Cardiothorac Surg. 2018 Feb 16. doi: 10.1093/ejcts/ ezy050.
6. Bonardelli S, Nodari F, De Lucia M, et al. Late open conversion after endovascular repair of abdominal aneurysm failure: Better and easier option than complex endovascular treatment. JRSM Cardio-vasc Dis. 2018 Mar 14;7:2048004017752835. doi: 10.1177/2048004017752835.
7. Parfir'ev Ju.M. Hirurgicheskoe lechenii anevrizm per-ifericheskih arterij Al'manah molodoj nauki. 2012. № 1. S. 57.
8. Timaran DE, Soto M, Knowles M, et al. Safety and effectiveness of total percutaneous access for fenes-
trated endovascular aortic aneurysm repair. J Vasc Surg. 2016 0ct;64(4):896-901.
9. Timaran CH, Stanley GA, Baig MS, et al. The sequential catheterization amid progressive endograft deployment technique for fenestrated endovascular aortic aneurysm repair. J Vasc Surg. 2017 Jul;66(1):311-315.
10. Manunga J., Sullivan T., Garberich R. et al Singlecenter experience with complex abdominal aortic aneurysms treated by open or endovascular repair using fenestrated/branched endografts. J Vasc Surg. 2018 Mar 3. pii: S0741-5214(18)30130-7.
11. Shalhub S, Eagle KA, Asch FM, et al. Endovascular thoracic aortic repair in confirmed or suspected genetically triggered thoracic aortic dissection. J Vasc Surg. 2018 Mar 19. pii: S0741-5214(18)30132-0.
12. Kozlov B.N., Panfilov D.S., Saushkin V.V., i dr. Voz-mozhnosti gibridnogo stent-grafta "e-vita open plus" v hirurgii grudnoj aorty. Angiologija i sosudistaja hirurgija. 2016. T. 22. № 3. S. 66-72.
13. Ban SP, Hwang G, Kim CH, et al. Risk factor analysis of recanalization and retreatment for patients with endovascular treatment of internal carotid artery bifurcation aneurysms. Neuroradiology. 2018 Mar 23. doi: 10.1007/s00234-018-2013-5.
14. Konczalla J, Platz J, Brawanski N, et al. Endovascular and surgical treatment of internal carotid bifurcation aneurysms: comparison of results, outcome, and mid-term follow-up. Neurosurgery. 2015 May;76(5):540-51.
15. Oishi H, Yamamoto M, Nonaka S, et al. Endovascular therapy of internal carotid artery bifurcation aneu-rysms. J Neurointerv Surg. 2013 Sep 1;5(5):400-4.
16. Knowles M, Nation DA, Timaran DE, et al. Upper extremity access for fenestrated endovascular aortic aneurysm repair is not associated with increased morbidity. J Vasc Surg. 2015 Jan;61(1):80-7.
17. Wooster M, Powell A, Back M, et al. Axillary Artery Access as an Adjunct for Complex Endovascular Aortic Repair. Ann Vasc Surg. 2015 Nov;29(8):1543-7.
18. Beljakin S.A., Pinchuk O.V., Obrazcov A.V., i dr. Diagnostika i lechenie perifericheskih arterial'nyh anevrizm nizhnih konechnostej Voenno-medicinskij zhurnal. 2014. T. 335. № 7. S. 24-27.
19. Bracale U.M., Corte G., Di Gregorio A. et al. Surgical repair of popliteal artery aneurysms remains a safe treatment option in the endovascular era: a 10-year single-center study // Ann. Ital. Chir. - 2011. - Vol. 82, N 6. - R. 443-448.
20. Antoniou G.A, Schiro A., Smyth J.V. et al. Multilayer stent in the treatment of popliteal artery aneurysms // Vasa. - 2012. - Vol. 41, N 5. - R. 383-387.
21. Baderkhan H, Haller O, Wanhainen A, et al. Follow-up after endovascular aortic aneurysm repair can be stratified based on first postoperative imaging. Br J Surg. 2018 Mar 26. doi: 10.1002/bjs.10766.
22. Arakeljan V.S., Papitashvili V.G. Anevrizmy nishod-jashhego grudnogo i torakoabdominal'nogo otdelov aorty: rezul'taty vmeshatel'stva Annaly hirurgii. 2016. T. 21. № 5. S. 300-305.
23. Tinelli G, Crea MA, de Waure C, et al. A propensity matched comparison of fenestrated endovascular aneurysm repair and open surgical repair of pararenal and paravisceral aortic aneurysms. J Vasc Surg. 2018 Mar 22. pii: S0741-5214(18)30257-X. doi: 10.1016/j.jvs.2017.12.060.
24. Wu D, Chesnokova AE, Akvan S, et al. Postoperative Chylothorax After Thoracoabdominal Aortic Aneurysm Repair. Semin Thorac Cardiovasc Surg. 2018 Feb 8. pii: S1043-0679(18)30012-1.
25. Mehta HB, Dimou F, Adhikari D, et al. Comparison of Comorbidity Scores in Predicting Surgical Outcomes. Med Care. 2016 Feb;54(2):180-7.
26. Gallitto E, Gargiulo M, Faggioli G, et al. Impact of iliac artery anatomy on the outcome of fenestrated and branched endovascular aortic repair. J Vasc Surg. 2017 Dec;66(6):1659-1667.
27. Nagel, M.A. and Gilden, D. Update on Varicella Zoster Virus Vasculopathy. Curr Infect Dis Rep. 2014; 16: 407.
28. Nagel, M.A., Bennett, J.L., Khmeleva, N. et al. Multifocal VZV vasculopathy with temporal artery infection mims giant cell arteritis. Neurology. 2013; 80: 2017-2202.
29. de Worm S, Giot JB, Courtoy C, et al. A case of giant cell arteritis associated with culture-proven Coxiella burnetii aortitis. Int J Infect Dis. 2018 Mar 2;69:50-54.
30. Pecoraro F, Gloekler S, Mader CE, et al. Mortality rates and risk factors for emergent open repair of abdominal aortic aneurysms in the endovascular era. Updates Surg. 2018 Mar;70(1):129-136.
31. Mozgovoj P. V., Zjubina E. N., Spiridonov E. G., i dr. Sravnitel'nyj analiz hirurgicheskogo i jendovaskul-jarnogo lechenija anevrizm brjushnoj aorty // Mezh-
dunarodnyj zhurnal intervencionnoj kardioangiologii. 2013. №35. S.62.
32. Kalesan B, Cheng TW, Farber A, et al. Readmissions after thoracic endovascular aortic repair. J Vasc Surg. 2018 Mar 2. pii: S0741-5214(18)30138-1. doi: 10.1016/j.jvs.2017.12.035.
33. Semenova L.N., Morova N.A., Potapov V.l., i dr. Postroenie ocenochnoj shkaly diagnostiki rasslaiva-jushhej anevrizmy grudnoj aorty na dogospital'nom jetape s ispol'zovaniem informacionnyh tehnologij Dinamika sistem, mehanizmov i mashin. 2016. T. 4. № 1. S. 107-114.
34. Dijkstra ML, Vainas T, Zeebregts CJ, et al. Spinal Cord Ischaemia in Endovascular Thoracic and Thoracoabdominal Aortic Repair: Review of Preventive Strategies. Eur J Vasc Endovasc Surg. 2018 Mar 7. pii: S1078-5884(18)30099-6.
35. Schuurmann RCL, van Noort K, Overeem SP, et al. Determination of Endograft Apposition, Position, and Expansion in the Aortic Neck Predicts Type la Endoleak and Migration After Endovascular Aneurysm Repair. J Endovasc Ther. 2018 Mar 1:1526602818764616. doi: 10.1177/1526602818764616.
36. Johnston WF, Salmon M, Su G, et al. Aromatase is required for female abdominal aortic aneurysm protection. J Vasc Surg. 2015 Jun;61(6):1565-74.e1-4.
37. Paraskevas Kl, Mikhailidis DP, Giannoukas AD. Additional issues on screening, prevention, and treatment of abdominal aortic aneurysms. Am J Mens Health.
2013 Nov;7(6):472-4.
38. Torsello G, Debus ES, Schmitz-Rixen T, et al. Ultrasound screening for abdominal aortic aneurysms - a rational measure to prevent sudden rupture].Dtsch Med Wochenschr. 2016 Jul;141(14):1030-4.
39. Sypert D, Van Dyke K, Dhillon N, et al. Improved Resident Adherence to AAA Screening Guidelines via an Electronic Reminder. J Healthc Qual. 2017 Jan/ Feb;39(1):e1-e9.
40. Olchanski N, Winn A, Cohen JT, et al. Abdominal aortic aneurysm screening: how many life years lost from underuse of the medicare screening benefit? J Gen Intern Med. 2014 Aug;29(8):1155-61.
41. Ruff AL, Teng K, Hu B, et al. Screening for abdominal aortic aneurysms in outpatient primary care clinics. Am J Med. 2015 Mar;128(3):283-8.
42. Hahn B, Bonhomme K, Finnie J, et al. Does a normal screening ultrasound of the abdominal aorta reduce the likelihood of rupture in emergency department patients? Clin Imaging. 2016 May-Jun;40(3):398-401.
43. Hye RJ, Smith AE, Wong GH, et al. Leveraging the electronic medical record to implement an abdominal aortic aneurysm screening program. J Vasc Surg.
2014 Jun;59(6):1535-42.
44. Sisy-Almirall A, Kostov B, Navarro Gonz6lez M, et al. Abdominal aortic aneurysm screening program using hand-held ultrasound in primary healthcare. PLoS One. 2017 Apr 28;12(4):e0176877. doi: 10.1371/jour-nal.pone.0176877.
45. van 't Hof FN, Ruigrok YM, Lee CH, et al. Shared Genetic Risk Factors of Intracranial, Abdominal, and Thoracic Aneurysms. J Am Heart Assoc. 2016 Jul 14;5(7). pii: e002603. doi: 10.1161/JAHA.115.002603. Erratum in: J Am Heart Assoc. 2018 Feb 2;7(3).
46. Weerakkody R, Ross D, Parry DA, et al. Targeted genetic analysis in a large cohort of familial and sporadic cases of aneurysm or dissection of the thoracic aorta. Genet Med. 2018 Mar 15. doi: 10.1038/ gim.2018.27.
47. Scheglov D.V., Pastushyn O.A., Sviridyuk O.E., et al. Endovascular treatment of distal cerebral aneurysms Endovaskuljarna nejrorentgenohirurgija. 2015. № 3 (13). S. 45-50.
48. Yamamoto T, Mori K, Esaki T, et al. Preventive effect of continuous cisternal irrigation with magnesium sulfate solution on angiographic cerebral va-sospasms associated with aneurysmal subarachnoid hemorrhages: a randomized controlled trial. J Neuro-surg. 2016 Jan;124(1):18-26.
49. Ten Brinck MFM, de Vries J, Bartels RHMA, et al. NeuroForm Atlas Stent-Assisted Coiling: Preliminary Results. Neurosurgery. 2018 Mar 21. doi: 10.1093/ neuros/nyy048.
50. Dijkstra ML, Vainas T, Zeebregts CJ, et al. Spinal Cord Ischaemia in Endovascular Thoracic and Tho-raco-abdominal Aortic Repair: Review of Preventive
Strategies. Eur J Vasc Endovasc Surg. 2018 Mar 7. pii: S1078-5884(18)30099-6.
51. Backes D, Rinkel GJ, van der Schaaf IC, et al. Recovery to Preinterventional Functioning, Return-to-Work, and Life Satisfaction After Treatment of Unruptured Aneurysms. Stroke. 2015 Jun;46(6):1607-12.
52. Ogola GO, Gale SC, Haider A, et al. The financial burden of emergency general surgery: National estimates 2010 to 2060. J Trauma Acute Care Surg. 2015 Sep;79(3):444-8.
53. Birkmeyer JD, Gust C, Dimick JB, et al. Hospital quality and the cost of inpatient surgery in the United States. Ann Surg. 2012 Jan;255(1):1-5.
54. van den Haak RF, Hamans BC, Zuurmond K, et al. Significant Radiation Dose Reduction in the Hybrid Operating Room Using a Novel X-ray Imaging Technology. Eur J Vasc Endovasc Surg. 2015 Oct;50(4):480-6.
55. Stangenberg L, Shuja F, van der Bom IMJ, et al. Modern Fixed Imaging Systems Reduce Radiation Exposure to Patients and Providers. Vasc Endovascular Surg. 2018 Jan;52(1):52-58.
