Tratamento endovascular das doenças da aorta torácica: análise dos resultados de um centro

Abstract

Objective: To analyze treatment outcomes in a consecutive series of patients submitted to endovascular treatment of thoracic aortic disease. Technical success, therapeutic success, morbimortality, rate of perioperative complications and reinterventions were taken into consideration. Materials and Methods: The present retrospective study was developed in a reference center in the period from January 2010 to July 2011, involving patients submitted to endovascular treatment of thoracic aortic disease. The study population was divided into two groups: group 1 (G1) -true thoracic aortic aneurysms, aortic ulcer and pseudoaneurysm; group 2 (G2) -chronic type B aortic dissection. Results: Out of a total of 55 patients, 29 belonged to the G1 and 26 to the G2 group. Mean ages were 66.8 ± 10 and 56.4 ± 7 years, respectively. The technical and therapeutic success reached respectively 86.3% and 68.6% in G1 and 100% and 74% in G2. The perioperative mortality rate was 10.3% in G1 and 19.3% in G2. The reintervention rate was 10.3% in G1 and 15.3% in G2. Conclusion: In the present study, the endovascular treatment of thoracic aortic disease proved to be a feasible method associated with acceptable rate of complications. Keywords: Aneurysm; Vascular graft; Atherosclerosis.Objetivo: Analisar os resultados do tratamento de uma série consecutiva de pacientes submetidos a tratamento endovascular de doenças da aorta torácica. Foram observados o sucesso técnico, o sucesso terapêutico, a morbimortalidade e a taxa de complicações perioperatórias e de reintervenções. Materiais e Métodos: Estudo retrospectivo, realizado em um centro de referência, no período de janeiro de 2010 a julho de 2011, em que foram analisados pacientes submetidos a correção endovascular de doenças da aorta torácica. A população foi dividida em dois grupos: grupo 1 (G1) -aneurismas de aorta torácica verdadeiros, úlcera aórtica e pseudoaneurisma; grupo 2 (G2) -dissecção aórtica tipo B crônica. Resultados: Em um total de 55 pacientes tratados, 29 pertenciam ao G1 e 26, ao G2. As idades médias foram 66,8 ± 10 e 56,4 ± 7 anos, respectivamente. Os sucessos técnico e terapêutico foram, respectivamente, 86,3% e 68,6% no G1 e 100% e 74% no G2. A mortalidade perioperatória foi 10,3% no G1 e 7,6% no G2, com taxa de mortalidade anual de 10,3% no G1 e de 19,3% no G2. As taxas de reintervenções foram 10,3% e 15,3%, respectivamente. Conclusão: Em nosso estudo, o tratamento endovascular das doenças da aorta torácica demonstrou ser um método viável e associado a aceitáveis taxas de complicações. Unitermos: Aneurisma; Prótese vascular; Aterosclerose. . Aortic dissection is the most feared condition of the aorta and is twice as frequent as aortic rupture. The mortality rate associated with dissection ranges between 1% and 2% per hour, during the first 48 hours. Risk factors frequently associated with such condition include hypertension, cardiovascular and respiratory diseases. Dissection is three times more frequent in men than in women. The most common entry 7. PhD, Head

Lesão de aorta simulando doença pulmonar: relato de caso

“…Currently, the management by means of endovascular prosthesis is preferred considering its less invasiveness as compared with the open repair ( 8 ) . Endovascular prosthesis can be used even in cases of aortic rupture, with lower morbidity and mortality ( 4 ) .…”

Evaluation of preoperative computed tomography angiography in association with conventional angiography versus computed tomography angiography only, in the endovascular treatment of aortic diseases

“…Digital AG remains as the standard in the investigation of parietal branches such as, for example, the bronchial arteries, intercostal arteries, and those arteries supplying the spinal cord (17)(18)(19)(20) . This has implications for the rate of complications.…”

Reflections

“…A part of those complications is explained by the known superiority of conventional AG for the study of the spinal arteries (2) . The second finding is the higher accuracy in the prosthesis calculation in the subgroup submitted to preoperative conventional AG, demonstrating that it can be a useful resource for a better surgical planning.…”