Even with the subsequent penetration of the blood flow in the modified degenerativo middle layer, education vnutristenocna bruises and longitudinal examination wall Even predominantly distalnom or less in the proximal direction. Stratification arteries was first described in 1761 Morgagni, and then in 1802 Maunoz. In 1819 the French school Laennec in clinical practice has been introduced the term "anewrisme dissequant (rasslaivataya anevrizma) left up to the present time, since by itself the arteries, in some cases, a moderate, it does not affect its domestic layer. This term is not entirely correct, but it is generally accepted. The first attempt to correct stratification predator had D. Gurin et al. in 1935 through the creation of distal fenestration at the outer face artery. In 1955 R. Shan repeated this operation at the ventral arteries. Both patients died of kidney failure. The first successful operation of distal fenestration in the descending thoracic arteries part has been made in the 1955 M. DeBakey. In 1955 M. DeBakey made a successful operation POE rasslaivatei Even with its prosthetic proximal fenestration which localized distalnee podklucicna left artery. In 1959 M. DeBakey performed the first operation at the rasslaivatei anevrizma bottom of lakes. In our country, such an operation was done in 1964 BV Petrovsky. In 1965 AV Pokrovsky operation with prosthetic breast descendants of the primitive in its stratification. Later Bentall M. (1968), J. Edwards (1974) and S. Cabrol (1981), taking into account the involvement pathological process fibrosny ring Valsalva sines and estuaries venechnykh arteries suggested various modifications simultaneous aortalni prosthetic valve and the ascending part Even klapansoderjasim "konduitom with reimplantation venechnykh arteries. Experience in the treatment of rasslaivath anevrizm Even in Russia gained ISSH them. Bakulev. Among the acute care Even its stratification can be most frequent disastrous, it is 2-3 times more often than, for example, the gap anevrizm ventral arteries. Even stratification occurs in 1 out of 10,000 hospitalized patients. However, a significant proportion of patients dying on the treatment stage. Rasslaivate anevrizma Even 1.1% of the cases are caused sudden death. According to the literature, the frequency distribution predator is 5-10 per 1 million people annually. Among anevrizm Even rasslaivate anevrizma up 6%, and among anevrizm breasts predator-20%. Classification Classification rasslaivath anevrizm Even usually based on the proximal localization of the inner lining arteries and the extent of the division wall arteries. As a gap inner lining arteries can occur anywhere and rivers are multiple theoretically options anevrizma distribution can be varied. Some authors provide, for example, three types of stratification breasts Even with the location of the defect inner lining up in the arteries, in the field of safety and in the initial segment of the descending arteries. In practice, however, the gap inner lining occurs mostly in the front wall of the ascending rivers on the border proksimalna and middle third, as well as in the initial segment of the descending arteries distalnee mouth podklucicna left artery. It is on this principle, and based classification M. DeBakey, which is shared by most local surgeons. However, in clinical practice to determine the prognosis of disease and a conservative and operational tactics is more appropriate modification of the classification, which is proposed in 1984 F. Robicsek : Type I-gap inner lining lies in the bottom of the lakes, and its disintegration wall extends to the ventral portion of mammals. Pathological process has two options : 1. horizontal wall is blind bag in the distal arteries divisions; 2. is the second gap distal arteries (distalnaya fenestration). Type II-gap inner lining lies in the bottom of the lakes, stratification is blind bag proksimalnee plechegolovny barrel. Type III-gap inner lining arteries localized in the initial section of the descending thoracic arteries distalnee mouth podklucicna left artery.
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