A comparison of results of sparing treatment obtained at 2, 4 and 6 years of follow-up in subjects with descending aortic atherosclerotic aneurysms (DAAs), and during the period between 1.5 and 8.9 years in subjects with dissecting thoracoabdominal aortic aneurysms (DTAAs) has been made. All subjects received conservative treatment to maintain optimal levels of BP, cholesterol and LDL cholesterol, as well as to reduce oxidative and inflammatory processes in aorta, strengthen aortic walls and stabilize the course of the disease. Rapid negative changes (diameter increased by more than 5 mm within a 6-month period) and the absence of contraindications for surgery prompted us to perform open or endovascular aortic repair. Available data suggest that both DAAs and TAAs are comorbidities, which at any time can abruptly terminate patient's life, and operative treatment guarantees no safety from ruptures. When using sparing treatment of DAA, survival rates were 90.1% at 2 years, 76.8% at 4 years, and 59.4% at 6 years, with uniform survival increment mainly due to comorbidity. Survival rate seen in TAA group (81.8%) was more acceptable due to a younger age of patients.

Descending aortic aneurysms (DAAs), including dissecting aneurysms (DA) have a multifactorial etiology and pathogenesis, therefore raising questions about the leading role of operative treatment to repair the lesion. Objective: To investigate remote (7 and more years) results of treatment in patients with DAAs in operative treatment only if there is a danger of aneurysm rupture. A total of 82 patients with atherosclerotic DAA identified between 2008 and 2011, and 22 patients with type 1 or 3 DeBakey dissecting aneurysms (DA) who had not been operated in the acute period due to a number of reasons were examined. The follow-up period of these groups was 7 or more years. When using a sparing treatment to treat DAA, we saw survival of 90.1 at 2 years, 76.8% at 4 years, 59.4% at 6 years, and 57.5% at 7 years with the uniform increase in mortality rate, mainly due to a comorbidity. Survival in DA group (77.3%) was better due to a younger age and was 68.4% in operated and 54% in non-operated patients at 7 years. It is symptomatic that the aneurysm rupture rate was not always affected by operative treatment. Therefore, it seems like medical treatment is more consistent with etiopathogenesis of the disease compared to surgery during the stabilization period.