Tratamento endovascular de aneurisma de artéria poplítea

Abstract

CONTEXTO: Dos aneurismas periféricos, o da artéria poplítea é o mais freqüente, correspondendo a 70 a 80% dos casos. O tratamento cirúrgico convencional consta de exclusão do aneurisma e interposição de enxerto em ponte ou de ressecção parcial ou total do aneurisma e reconstrução arterial com enxerto em continuidade. O tratamento endovascular surgiu como uma alternativa ao reparo convencional. OBJETIVO: Avaliar o uso de endoprótese para o tratamento endovascular do aneurisma de artéria poplítea. METODOLOGIA: Num total de 17 pacientes, todos do sexo masculino, 11 foram tratados por técnica endovascular, utilizando-se próteses Hemobahn e Viabahn. RESULTADOS: Um paciente apresentou pseudo-aneurisma no pós-operatório imediato. Dentre as complicações tardias, um paciente apresentou endoleak distal da prótese após 7 meses, e houve oclusão da endoprótese em outro. Os nove pacientes restantes apresentaram controle de eco-Doppler satisfatório aos 20 meses, resultando em uma perviedade primária de 90% em um período médio de 27 meses de seguimento. CONCLUSÃO: O tratamento endovascular para aneurisma de artéria poplítea é factível e apresenta algumas vantagens em relação ao tratamento aberto, como menor tempo de internação e de recuperação.

Cirurgia aberta e endovascular no tratamento de aneurisma de artéria poplítea: experiência de cinco anos do HCRP-FMRP-USP

“…31 Studies report primary patency of 86% to 95% and secondary patency of 96.90% to 100% for aneurysms repaired with elective endovascular surgery. [31][32][33][34] Cases repaired with great saphenous vein grafts by conventional surgery have patency of 78.80% to 87.50% in the first year, with limb salvage rates of 94.30%. 20,26 Our patient sample was comparable with previous studies, with stent patency of 80% during the first year and limb survival of 100% over the first 90 days after ES, while cases treated with OS had 95.23% patency in the first month and 75% after 1 year, and a 90-day limb survival rate of 95.23%, including emergency cases.…”

Case report: rupture of popliteal artery aneurysm

“…1,4,5,7 Popliteal artery aneurysms have multifactorial etiology and their cause has not been completely elucidated, although atherosclerosis is the favored hypothesis for elderly patients. [7][8][9] Patients may be asymptomatic or they may present with ischemic symptoms related to thrombosis of the aneurysm or an embolic event secondary to it, which can occur in 33% of cases.…”

“…They have greatest incidence in men over 65 years of age and in 50% of cases they are bilateral. 1 While etiology is multifactorial, the most common agent is atherosclerosis; clinical diagnosis only occurs when arterial dilation has attained large dimensions or when ischemic complications in the limb emerge. 2 Clinical manifestations of PAA include acute arterial thrombosis, distal embolization, compression of veins and/or nerves and rupture, the last of which is a rare complication.…”

“…2 Clinical manifestations of PAA include acute arterial thrombosis, distal embolization, compression of veins and/or nerves and rupture, the last of which is a rare complication. 1 Nowadays, endovascular surgery has become established as an alternative treatment to open repair of PAA, since it offers certain advantages, such as reduced blood loss, more rapid postoperative recovery and earlier hospital discharge. 3,4 We report a rare case of PAA rupture that was treated in the emergency room using endovascular techniques.…”

A System to Help Physicians With Fracture Detection in Stents

“…The implantation of stents in the peripheral vascular region is widely used as a solution for endovascular treatment. However, studies have pointed out that problems related to stent fractures occur with a certain frequency and must be diagnosed and properly treated (1)(2)(3)(4). Currently, computed tomography can be considered one of the best techniques for acquisition of stent images (5)(6)(7).…”