Mortalidade relacionada ao tratamento endovascular do aneurisma da aorta abdominal com o uso dos modelos revisados

Abstract

Mortalidade relacionada ao tratamento endovascular do aneurisma da aorta abdominal com o uso dos modelos revisadosProcedure-related mortality of endovascular abdominal aortic aneurysm repair using revised reporting standards Abstract Objective: The aim of this study was to evaluate the definition of Procedure-related mortality after endovascular aneurysm repair (EVAR) as defined by the Committee for Standardized Reporting Practices in Vascular Surgery.Methods: Data on patients with an AAA were taken from the EUROSTAR database. The patients underwent EVAR between June 1996 and February 2004 and were analyzed retrospectively. Explicit probability of cause of death was recorded. The time interval from operation, hospital discharge or second interventions till death was recorded.Results: A total of 589 out of 5612 patients (10.5%) died after EVAR in total follow up and all causes of death were included. 141 (2.5%) patients died due to aneurysms reported after the EVAR procedure of which 28 (4.8%) were ruptures, 25 (4.2%) graft-infections and 88 (14.9%) patients who died within 30 days after the initial procedure (present definition, also known as short term clinical outcome). In addition 25 patients died after 30 days, but were then (at moment of death) still in the hospital, or were transferred to a nursing home for further re-evaluation, or needed second interventions. Taking into account the duration of hospitalization and mortality immediately after procedurerelated second interventions, 49 delayed deaths might also be regarded as being EVAR procedure-related.Conclusion: Delayed deaths are a considerable proportion of procedure-related deaths after EVAR within the revised time frame.

Fatores de risco associados e sobrevida em curto e médio prazo de pacientes submetidos a correção aberta e endovascular de aneurisma de aorta abdominal

“…A retrospective Brazilian study of patients who received endovascular treatment from June 1996 to February 2004, based on analysis of a database from the European Collaborators on Stent-graft Techniques for Abdominal Aortic Aneurysm Repair (EUROSTAR) project, found that mean duration of the procedure was 137 minutes (25 to 287 min) and mean hospital stay was 6 days (0 to 163). 22 In the present study, the median length of hospital stay was shorter for endovascular treatment (2 days) than for open surgery (4 days) and both were shorter than the study just cited. This could be because of improved techniques and materials and consolidation of the surgical team's organization.…”

Estudo comparativo entre tratamento endovascular e cirurgia convencional na correção eletiva de aneurisma de aorta abdominal: revisão bibliográfica

“…Quanto ao tempo de permanência na UTI, verificou-se 2,8 dias para o REVA versus 6,5 dias para a cirurgia convencional 1,11 . A duração média da internação dos pacientes que faleceram 30 dias após a alta hospitalar foi de 47 dias 13 .…”

“…Nos estudos utilizados para esta revisão, a mortalidade perioperatória -ocorrida dentro de 30 dias do pós-operatório -foi menor no grupo REVA em comparação com a cirurgia convencional, apresentando valores entre 1,2 e 14,9% 1,3,7,10,11,13,15 . O EVAR Trial 1 evidenciou mortalidade perioperatória de 1,7% no REVA e de 4,7% no método convencional 7 .…”

“…No EVAR Trial 2, não houve diferença na mortalidade relacionada ao aneurisma e a outras causas, pois ocorreram 23 mortes por ruptura de aneurisma no grupo de acompanhamento clínico e 13 mortes pósoperatórias e nove tardias por ruptura de aneurisma no grupo REVA 3 . Conforme Koning et al, a mortalidade relacionada ao procedimento foi de 1,6% por ano 13 .…”

Morbi-Mortalidade Em Cirurgia De Correção De Aneurisma De Aorta Em Um Hospital Público De Fortaleza-Ce: Estudo Retrospectivo

“…Segundo Koning et al 15 o aumento da morbimortalidade dos pacientes que realizaram cirurgia para correção endovascular de aneurisma de aorta não está definida, não sabendo ainda se está ou não relacionada à técnica cirúrgica. Bonamigo, Lucas, Pereira 16 estudou os riscos da correção cirúrgica de aneurisma de aorta em pacientes jovens (< 50 anos) onde encontrou que a mortalidade perioperatória é nula e a sobrevida é boa.…”