Radiologic Diagnosis of Complicated Abdominal Aortic Aneurysms

The complicated abdominal aortic aneurysms are a difficult challenge for contemporary vascular surgery. The prompt diagnosis of pre-raptured cases gives an excellent opportunity for treatment results improvement. Aim: determination and arrangement of diagnostic criteria of the complicated aortic aneurysms. Materials and methods. A retrospective and prospective analysis of diagnostic results of 1015 patients with abdominal aortic aneurysms (AAA) were performed. The clinical symptoms of complications (abdominal pains in many cases) were revealed in 149 (14.68%) of patients. All cases with ruptured AAA (184 (8.13%) were excluded. The ultrasound duplex, computed tomography and PET-CT in nine cases were done. Results. The signs of complicated aneurysm (unstable and inflammatory aneurysms, impending rupture) were revealed in 156 patients (15.37%) separately or in combination. Such applicable for clinical use radiologic criteria were well-defined and described. The local lysis or disappearance of intraluminal thrombi, local dissection or protrusion of the aneurysmal wall, formation of secondary aneurysms and partial rupture were the most informative criteria. The local lesions of aortic wall were most specific for pre-ruptured forms of AAA. Conclusion. Defined criteria for diagnosis of the complicated, non-ruptured, abdominal aortic aneurysms permit to reveal such complication on time and to prevent a life-threatening rupture.

осложненные аневризмы брюшной аорты, компьютерно-томографическая ангиография, дуплексное сканирование, неотложная лучевая диагностика, complicated abdominal aortic aneurysm, duplex scanning, computed tomographic angiography, emergency radiology diagnosis

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