Correção endovascular do aneurisma da aorta abdominal: análise dos resultados de único centro

Novero, Eduardo Rafael; Metzger, Patrick Bastos; Angelieri, Fernanda; Colli, Marcelo Bueno de Oliveira; Moreira, Samuel Martins; Izukawa, Nilo Mitsuru; Rossi, Fábio Henrique; Kambara, Antônio Massamitsu

doi:10.1590/s0100-39842012000100003

Cited by 7 publications

(17 citation statements)

References 23 publications

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“…In the treatment of patients with increasingly severe conditions, the improvement of prostheses and refinement of the endovascular techniques are accompanied by encouraging results 1 . Several techniques are available for the treatment of aneurysms 2 , 3 , 4 , but in the case reported herein the inner tubing technique was chosen, which was developed for bifurcation lesions where conventional vascular endoprosthesis are unavailable or the anatomy does not fit the available endoprosthesis 5 . The aortomonnoiliac endovascular grafting technique would be, indeed, an adequate procedure for this case, but it would involve a higher surgical risk and the requirement of an aortic endoprosthesis that was unavailable in our service.…”

Section: Discussionmentioning

confidence: 99%

Inner tubing technique used for the treatment of anastomotic aneurism

Gaspar¹,

Mattos²,

Sofia³

et al. 2016

ACR

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The authors report the case of a 66-year-old male patient diagnosed with a pseudoaneurysm of the distal aorto-aortic anastomosis treated with the inner tubing technique. The patient had been operated on 1 year before when he had an aortic prosthesis implanted as treatment for a ruptured abdominal aortic aneurysm. The inner tubing technique was developed to facilitate the treatment in bifurcated vascular lesions, where endovascular conventional prosthesis is not available.

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Section: Discussionmentioning

confidence: 99%

Inner tubing technique used for the treatment of anastomotic aneurism

Gaspar¹,

Mattos²,

Sofia³

et al. 2016

ACR

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“…Images reformatting and display in the coronal, sagittal and three-dimensional allow a better evaluation. The quality of such images reconstruction depends upon expensive post-processing techniques (15,16) , for this reason arteriography is more useful in the calculation and planning of extensions in the contra-or ipsilateral legs, due to tortuosities frequently observed in such cases.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2013

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Avaliação da realização pré-operatória da angiotomografia associada a angiografia convencional versus angiotomografia apenas no tratamento endovascular das doenças da aorta Objective: To evaluate the association of conventional angiography (AG) with computed tomography angiography (CTA) as compared with CTA only, preoperatively, in the treatment of aortic diseases. Materials and Methods: Retrospective study involving patients submitted to endovascular treatment of aortic diseases, in the period from January 2009 to July 2010, with use of preoperative CTA + conventional AG or CTA only. The patients were divided into two groups, namely: G1 -thoracic aortic diseases; and G2 -abdominal aortic diseases. G1 was subdivided into 1A (preoperative AG + CTA) and 1B (preoperative CTA). G2 was subdivided into 2C (CTA + AG) and 2D (CTA only). Results: The authors evaluated 156 patients. In subgroups 1A and 1B, the rate of technical success was, respectively, 100% and 94.7% (p = 1.0); and the rate of therapeutic success was, respectively, 81% and 58% (p = 0.13). A higher number of complications were observed in subgroup 1B (p = 0.057). The accuracy in the calculation of the prosthesis was higher in subgroup 1A (p = 0.065). In their turn, the rate of technical success in subgroups 2C and 2D was, respectively, 92.3% and 98.6% (p = 0.17). The rate of therapeutic success was 73% and 98.6% (p = 0.79). Conclusion: Preoperative conventional AG should be reserved for cases where CTA cannot provide all the information in the planning of a therapeutic intervention. Keywords: Aneurysm; Vascular prosthesis; Angiography.Objetivo: Avaliar a associação entre angiografia (AG) e angiotomografia (ATG) pré-intervenção, comparada apenas à ATG, no tratamento de doenças aórticas. Materiais e Métodos: Estudo retrospectivo, envolvendo pacientes submetidos a tratamento endovascular de doenças aórticas, no período de janeiro de 2009 a julho de 2010, com o uso de AG + ATG pré-operatória ou apenas ATG. Os pacientes foram divididos em: G1 -doenças da aorta torácica; G2 -doenças da aorta abdominal. O G1 foi subdividido em 1A (submetidos a AG + ATG pré-operatória) e 1B (ATG pré-operatória). O G2 foi subdividido em 2C (ATG + AG) e 2D (ATG). Resultados: Foram analisados 156 pacientes. Nos subgrupos 1A e 1B, o sucesso técnico foi 100% e 94,7% (p = 1,0) e o sucesso terapêutico de 81% e 58%(p = 0,13). Foram observadas mais complicações no subgrupo 1B (p = 0,057). A precisão do cálculo da prótese foi maior no subgrupo 1A (p = 0,065). Por sua vez, nos subgrupos 2C e 2D, o sucesso técnico foi 92,3% e 98,6% (p = 0,17) e o sucesso terapêutico foi 73% e 98,6% (p = 0,79). Conclusão: A AG diagnóstica deve ser reservada aos casos em que a ATG não é capaz de fornecer todas as informações necessárias no planejamento de uma intervenção terapêutica. Unitermos: Aneurisma; Prótese vascular; Angiografia.

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“…Avoiding aortic clamping with the endovascular technique reduces the complications by ischemia of the target organ, as well as cardiac (1% versus 10%), respiratory (8% versus28%) and renal complications, as compared with open surgery (13) . On the other hand, injury of the arterial access path caused by the combination of a high-profile delivery system (20)(21)(22)(23)(24) French) and iliac-femoral atherosclerosis is very frequently observed in procedures with the endovascular technique.…”

Section: (7)mentioning

confidence: 99%

“…The main disadvantage of the preoperative drainage is the potential development of spinal hematoma in cases where heparin is administered during the intervention. In such an event, the cerebrospinal fluid drainage must be suspended (20,21) . In the present study, 17% of the G1 population received continuous spinal anesthesia catheter, while in G2, only 10% of the patients received it.…”

Section: (7)mentioning

confidence: 99%

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

Novero¹,

Metzger²,

Obregon³

et al. 2012

Radiol Bras

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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

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Correção endovascular do aneurisma da aorta abdominal: análise dos resultados de único centro

Cited by 7 publications

References 23 publications

Inner tubing technique used for the treatment of anastomotic aneurism

Inner tubing technique used for the treatment of anastomotic aneurism

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

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

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