Медицина неотложных состояний (Nov 2023)
Emergency treatment of ruptured abdominal aneurysm
Abstract
Background. Abdominal aneurysm is considered a formidable pathological condition that requires prompt treatment. Despite the improvement of medical equipment and postoperative care, mortality due to ruptured abdominal aneurysm is still close to 50 %. The purpose of this review was to investigate and evaluate currently available techniques for treating ruptured abdominal aneurysm to find best methods. Materials and methods. Using keywords and inclusion/exclusion criteria, a search, analysis, and systematization of information sources from foreign databases for the last 5–10 years was carried out. Results. It was found that endovascular aortic aneurysm correction is the optimal method for both planned and emergency treatment of aortic aneurysm and its rupture. According to the Cochrane Specialized Register, it was found that endovascular repair is associated with a reduction in early morbidity and mortality after abdominal aneurysm, compared with other methods of surgical treatment. Conclusions. The study revealed that unlike open methods of surgery, endovascular techniques are associated with a lower risk of complications in the form of intestinal ischaemia. However, there is currently no sufficient evidence base to confirm a lower risk of complications from other organ systems. Similarly, to date, no difference in mortality rates has been found one month after surgery comparing endovascular and open surgical methods, which requires further research. Data from this review can be used for further, broader analyses of the literature, as well as for the design of original clinical trials.
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