Authors
Kalmykov E.L.1,2, Suchkov I.A.2, Gaibov A.D.3, Kalinin R.E.2, Nematzoda O.4, Dodkhoev D.S.3
1 Clinic for Vascular and Endovascular Surgery, Brandenburg, Germany
2 Ryazan State Medical University, Ryazan
3 Avicenna Tajik State Medical University, Dushanbe, Republic of Tajikistan
4 The Republican Scientific Center for Cardiovascular Surgery, Dushanbe, Republic of Tajikistan
Abstract
The aim of the study was a comparative analysis of the results of surgical treatment of patients with iAAA in different Countries and clinics.
Material and methods. The study is retrospective, comparative and is based on the analysis of the results of surgical treatment of patients with iAAA, in the period from 2011 to 2015 at the base of the Ryazan State Medical University named after acad. I.P. Pavlov, Ryazan, Russia and at the Republican Scientific Center for Cardiovascular Surgery (RSCCS), Dushanbe, Tajikistan (2011-2017). The study included 226 patients, 60 from Dushanbe and 166 from Ryazan. The endpoints of the study were: demographic characteristics, comorbidities, time of surgical treatment, mortality within 30 days after surgery, long-term survival, the effect of gender on survival.
Results. The mean age of the patients was 69.4±2.6 years, males 174 (77%), females 52 (23%). Patients older than 80 years were 11.4% and 23.4% in Russia and Tajikistan, respectively. Only in 69.7% and 73.3% of cases were elective surgery performed. Cumulative 30-day mortality, as well as 30-day mortality after elective and emergency operations, was comparable between the clinics. The 30-day mortality rate was higher after operations performed for AAA rupture compared to elective surgery. The duration of observation of patients in Dushanbe and Ryazan was 21.0±0.9 (M±SE; min-max=11-33) and = 21.0±0.5 (M±SE; min-max=2-33) months. Mortality was not differ in both countries. The survival rate up to 33 months reached 74%. In the Russian Federation after the operation, the total mortality during the first 30 days turned out to be significantly higher among males, in the Republic of Tajikistan was not differ.
Conclusion. Surgical interventions for AAA rupture are performed in 26-31% in the Republic of Tatarstan and the Russian Federation, respectively. Cumulative 30-day mortality, 30-day mortality after elective and emergency operations are comparable between compared clinics. AAA rupture is accompanied by high mortality. RF after the operation, the total mortality during the first 30 days was significantly higher among males.
Keywords: abdominal aortic aneurysm; survival; mortality, gender.
References
1. Rutherford's Vascular Surgery and Endovascular Therapy, 2-Volume, 10th Edition. Elsevier; 2023. P. 2928.
2. Wanhainen A, Verzini F, Van Herzeele I, Allaire E, Bown M, Cohnert T, et al. 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; 57(1): 8-93. doi: 10.1016/j.ejvs.2018.09.020.
3. Zommorodi S, Leander K, Roy J, Steuer J, Hultgren R. Understanding abdominal aortic aneurysm epidemiology: socioeconomic position affects outcome. J Epidemiol Community Health. 2018; 72(10): 904-10. doi: 10.1136/jech-2018-210644.
4. Lilja F, Wanhainen A, Mani K. Changes in abdominal aortic aneurysm epidemiology. J Cardiovasc Surg (Torino). 2017; 58(6): 848-53. doi: 10.23736/S0021-9509.17.10064-9.
5. Kalmykov EL, Ahmad W, Suchkov IA, Kalinin RE, Nematzoda O, Gaibov AD, et al. Demographic Differences in Patients with Abdominal Aortic Aneurysm in 3 Different Countries: Germany, Tajikistan and Russian Federation. Novosti Khirurgii. 2021; 29(5): 535-41. doi: 10.18484/2305-0047.2021.5.535.
6. Kalmykov EL, Suchkov IA, Kalinin RE, Ne’matzoda O, Dodkhoyev DS. The Role and Significance of Polymorphisms of Certain Genes in Patients with Abdominal Aortic Aneurysm. I.P. Pavlov Russian Medical Biological Herald. 2022; 30(4): 437-445. (In Russ.) doi: 10.17816/PAVLOVJ108311.
7. Mani K, Lees T, Beiles B, Jensen LP, Venermo M, Simo G, Palombo D, Halbakken E, Troëng T, Wigger P, Björck M. Treatment of abdominal aortic aneurysm in nine countries 2005-2009: a vascunet report. Eur J Vasc Endovasc Surg. 2011; 42(5): 598-607. doi: 10.1016/j.ejvs.2011.06.043.
8. Asfandiyarova NS, Dashkevich OV, Zaikina EV, et al. Gender and age structure of multiple chronic diseases in patients of Ryazan region. The Clinician. 2017; 11(3-4): 65-72. (In Russ.) doi: 10.17650/1818-8338-2017-11-3-4-65-72.
9. Chaikof EL, Dalman RL, Eskandari MK, Jackson BM, Lee WA, Mansour MA, et al. The Society for Vascular Surgery practice guidelines on the care of patients with an abdominal aortic aneurysm. J Vasc Surg. 2018; 67(1): 2-77.e2. doi: 10.1016/j.jvs.2017.10.044.
10. Soleyko EV, Kakturskiy LV. Complicated chronic postinfarction heart aneurysm (clinical and morphological parallels). Nauka molodikh. 2013; 3: 7-12. (In Russ.)
11. Behrendt CA, Sedrakyan A, Rieß HC, Heidemann F, Kölbel T, Petersen J, et al. Short-term and long-term results of endovascular and open repair of abdominal aortic aneurysms in Germany. J Vasc Surg. 2017; 66(6): 1704-11.e3. doi: 10.1016/j.jvs.2017.04.040.
12. Chan WK, Yong E, Hong Q, Zhang L, Lingam P, Tan GWL, et al. Systematic review and meta-analysis of the prevalence of abdominal aortic aneurysm in Asian populations. J Vasc Surg. 2021; 73(3): 1069-74.e1. doi: 10.1016/j.jvs.2020.08.140.
13. Hicks CW, Canner JK, Arhuidese I, Obeid T, Black JH 3rd, Malas MB. Comprehensive Assessment of Factors Associated With In-Hospital Mortality After Elective Abdominal Aortic Aneurysm Repair. JAMA Surg. 2016; 151(9): 838-45. doi: 10.1001/jamasurg.2016.0782.
14. Gawenda M, Brunkwall J. Ruptured abdominal aortic aneurysm: the state of play. Dtsch Arztebl Int. 2012; 109(43): 727-32. doi: 10.3238/arztebl.2012.0727.
15. Hicks CW, Obeid T, Arhuidese I, Qazi U, Malas MB. Abdominal aortic aneurysm repair in octogenarians is associated with higher mortality compared with nonoctogenarians. J Vasc Surg. 2016; 64(4): 956-65.e1. doi: 10.1016/j.jvs.2016.03.440.
16. Stoberock K, Kölbel T, Atlihan G, Debus ES, Tsilimparis N, Larena-Avellaneda A, et al. Gender differences in abdominal aortic aneurysm therapy – a systematic review. Vasa. 2018; 47(4): 267-71. doi: 10.1024/0301-1526/a000703.
