Tratamento Endovascular dos Aneurismas de Artéria Poplítea

Abstract

Background: With the recent advances in endovascular techniques and the emergence of more flexible endoprosthesis, the treatment of popliteal artery aneurysms has become more frequent. The objective of this study was to evaluate the short and mid-term clinical outcomes of the treatment of popliteal artery aneurysms with the use of a flexible endoprosthesis. Methods: Retrospective longitudinal study conducted in two sites from January of 2011 to February of 2014. Populational characteristics, procedure-related data, and radiologic imaging were evaluated at a mean follow-up of 1 year. Morbidity and mortality rates, complication rates, and stent patency rates were obtained. Results: A total of 13 male patients, mean age 66 ± 9 years, were submitted to popliteal artery aneurysm treatment in 15 limbs. Run-off vessel evaluation showed that most patients had at least two patent arteries in the legs (92.3%). Stents were implanted in the middle segment in 57.1% and in the distal segment of the popliteal artery in 42.9% of the procedures. Target lesion revascularization was achieved in all of the cases and two stents were required in four limbs. Seventeen Viabahn™ and two Multilayer™ stents were used. During the 12-month follow-up there were no stent fractures. The primary patency rate was 53.3% and limb salvage rate was 100%. Conclusions: Endovascular treatment of popliteal artery aneurysm was shown to be effective in the mid-term follow-up.

Consenso de Revascularización de Miembros Inferiores del Colegio Argentino de Cardioangiólogos Intervencionistas CACI 2018

“…Tal son los pacientes clasifi cados como Fontaine III y IV o Rutherford 4 a 6. Los más recientes consensos europeos 163 defi nen la ICM como: Dolor de reposo isquémico persistente o recurrente que requiere analgesia opiácea durante 2 semanas y presión sistólica en el tobillo inferior a 50 mm Hg o presión sistólica en pié inferior a 30 mm Hg; o ulceración o gangrena del pie o los dedos de los pies y la presión sistólica del tobillo inferior a 50 mm Hg; o presión sistólica en pie inferior a 30 mm Hg. Al 1 año, sólo el 5% tendrá una supervivencia libre de amputación si no recibe un procedimiento de revascularización.…”

“…Un bypass fallido agrega a la gangrena las heridas quirúrgicas que deberán cicatrizar, además de la sección de circulación colateral que habitualmente se encuentra en el plano muscular o subcutáneo (Figura 3). La Sociedad Europea de Cirugía Vascular, publicó un Consenso algo más completo y detallado, con una orientación más anatómica que clínica 163 . En síntesis, este refi ere que cuando la anatomía arterial es favorable, es mejor realizar un procedimiento percutáneo, que implica entre otras cosas, una menor agresividad para el paciente.…”