Tratamento endovascular da dissecção crônica de aorta tipo B complicada

Abstract

Background: Endovascular repair of aortic diseases is a well-established therapeutic alternative for patients with the appropriate anatomy and/or high surgical risk, as it provides lower morbidity and mortality rates. This study aimed to analyse the outcomes of asymptomatic patients undergoing endovascular treatment of thoracic aortic dissections with an aortic diameter > 5.5 cm or endoleaks. Technical success, therapeutic success, morbidity, mortality, and perioperative complication and reintervention rates were assessed. Methods: The present retrospective study, which was performed at a reference centre from January, 2010 to July, 2011, analysed consecutive patients undergoing endovascular repair of chronic complicated type B aortic dissections based on the Stanford classification. Results: Twenty-six patients were treated. The mean age was 56.4 ± 7 years, and 61.5% were males. Technical and therapeutic success rates were 100% and 74%, respectively. The perioperative mortality was 7.6%, and the mortality rate in the first year of follow-up was 19.3%. The reintervention rate was 15.3%. Conclusions: In the present study, endovascular treatment of chronic type B aortic dissections proved to be a feasible method associated with acceptable perioperative complication rates. The therapeutic success and reintervention rates indicated the

Hybrid Treatment of Aortic Arch Disease.

“…The improvement of endovascular techniques and the association to surgical revascularization of the supra-aortic trunks allowed its application in aortic arch diseases, territory in which the conventional surgical treatment can bring high morbimortality rates [ 11 ] . Systematic reviews and recent clinical studies have confirmed the benefits of endovascular method over conventional surgery in this aortic segment [ 1 - 3 , 7 , 11 - 13 ] . A suitable anchoring zone in which there is at least 2 cm of healthy aortic extension is required for proper stent implantation, thereby preventing type I endoleak and maintaining the prosthesis durability for a long period [ 14 ] .…”

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.…”

Abordagens Técnicas Em Cirurgia De Aneurisma De Aorta Abdominal

“…Ao oferecer uma gama mais ampla de abordagens terapêuticas, essas técnicas permitem uma personalização ainda maior do tratamento, adaptando-se às necessidades individuais de cada paciente. O desenvolvimento contínuo dessas técnicas, aliado aos avanços tecnológicos, promete continuar a melhorar os resultados e a qualidade de vida dos pacientes com AAA 2,8 .…”

“…Os pacientes submetidos ao EVAR geralmente têm um tempo de internação hospitalar mais curto em comparação com a cirurgia aberta, o que reduz os custos hospitalares e o risco de infecções hospitalares. Além disso, devido à natureza minimamente invasiva do procedimento, os pacientes podem retornar às suas atividades normais mais rapidamente após o EVAR, melhorando significativamente a qualidade de vida pós-operatória 3,8 .…”

“…2. Necessidade de Estudos Adicionais: No entanto, são necessários estudos adicionais para avaliar a eficácia a longo prazo dessas abordagens e determinar sua posição em relação à cirurgia aberta e ao EVAR 4,8 .…”