Jornal Vascular Brasileiro
https://jvascbras.org/article/doi/10.1590/S1677-54492007000300004
Jornal Vascular Brasileiro
Original Article

Sobrevida tardia de pacientes submetidos à correção aberta eletiva de aneurisma de aorta abdominal

Late survival of patients submitted to elective abdominal aortic aneurysm open repair

Fábio Hüsemann Menezes; George Carchedi Luccas; Irene Akie Matsui

http://dx.doi.org/10.1590/S1677-54492007000300004 J Vasc Bras, vol.6, n3, p.218-224, 2007
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Resumo

CONTEXTO: Os autores fazem uma revisão dos pacientes operados em hospital privado para determinar a causa da mortalidade tardia, a evolução dos demais segmentos da aorta e as complicações relacionadas à prótese. OBJETIVOS: Relatar o seguimento tardio de uma série de 76 casos operados eletivamente para a correção de aneurisma de aorta abdominal, no período de março de 1995 a janeiro de 2007. MÉTODOS: Convocação dos pacientes para uma consulta de retorno e daqueles que não puderam comparecer pessoalmente através de contato telefônico. RESULTADOS: A mortalidade operatória em 30 dias foi de 5,3%. A sobrevida tardia obtida por curva atuarial foi de 95% em 1 ano, 88% em 3 anos e 72% em 8 anos. As doenças cardiovasculares foram a principal causa de mortalidade tardia, seguidas das neoplasias malignas. A dilatação de segmento de aorta proximal à correção cirúrgica ocorreu em 9,7% dos pacientes operados, e as complicações relacionadas à prótese ocorreram em quatro casos (5,3%), sendo uma infecção de prótese, um pseudo-aneurisma proximal, um pseudo-aneurisma em ilíaca e uma oclusão de ramo. CONCLUSÃO: A cirurgia aberta para correção do aneurisma de aorta abdominal apresenta bom resultado em longo prazo, semelhante ao da literatura nacional e internacional, sendo uma boa opção para o paciente que tenha um baixo risco cirúrgico.

Palavras-chave

Aneurisma da aorta abdominal, cirurgia, análise de sobrevida

Abstract

BACKGROUND:The authors performed a review of patients who underwent surgery at a community hospital to determine the cause of late mortality, evolution of other aortic segments and graft-related complications. OBJECTIVES: To report the late follow-up of a series of 76 patients submitted to elective abdominal aortic aneurysm open repair from March 1995 to January 2007. METHODS: Recruitment of patients for a follow-up visit; those who could not attend personally were contacted by telephone. RESULTS: Thirty-day operative mortality was 5.3%. Late survival obtained by life table was 95% in 1 year, 88% in 3 years and 72% in 8 years. Cardiovascular diseases were the main cause of late mortality, followed by malignant neoplasia. Dilatation of proximal aortic segment during follow-up occurred in 9.7% of the patients, and graft-related complications occurred in four cases (5.3%): one graft infection, one proximal pseudoaneurysm, one pseudoaneurysm of the iliac artery and one branch occlusion. CONCLUSION: Open surgery for abdominal aortic aneurysm repair has good long-term outcome, similar to that in the national and international literature, and is a good option for patients who have a low surgical risk.

Keywords

Abdominal aortic aneurysm, surgery, survival analysis

Referências

Conway KP, Byrne J, Townsend M, Lane IF. Prognosis of patients turned down for conventional abdominal aortic aneurysm repair in the endovascular and sonographic era: Szilagyi revisited?. J Vasc Surg.. 2001;33:752-7.

Brewster DC, Cronenwett JL, Hallett JW. Guidelines for the treatment of abdominal aortic aneurysms: Report of a subcommittee of the Joint Council of the American Association for Vascular Surgery and Society for Vascular Surgery. J Vasc Surg.. 2003;37:1106-17.

Biancari F, Ylönen K, Anttila V. Durability of open repair of infrarenal abdominal aortic aneurysm: A 15-year follow-up study. J Vasc Surg.. 2002;35:87-93.

Cherr GS, Edwards MS, Craven TE. Survival of young patients after abdominal aortic aneurysm repair. J Vasc Surg.. 2002;35:94-9.

Taylor JC, Shaw E, Whyman MR, Poskitt KR, Heather BP, Earnshaw JJ. Late survival after elective repair of aortic aneurysms detected by screening. Eur J Vasc Endovasc Surg.. 2004;28:270-3.

Back MR, Leo F, Cuthbertson D, Johnson BL, Shames ML, Bandyk DF. Long-term survival after vascular surgery: Specific influence of cardiac factors and implications for preoperative evaluation. J Vasc Surg.. 2004;40:752-60.

Cao P, Verzini F, Parlani G. Clinical effect of abdominal aortic aneurysm endografting: 7-year concurrent comparison with open repair. J Vasc Surg.. 2004;40:841-8.

Lifeline registry of endovascular aneurysm repair: Long-term primary outcome measures. J Vasc Surg.. 2005;42:1-10.

Adam DJ, Fitridge RA, Raptis S. Late reintervention for aortic graft-related events and new aortoiliac disease after open abdominal aortic aneurysm repair in an Australian population. J Vasc Surg.. 2006;43:701-5.

Becker M, Bonamigo TP, Faccini FP. Avaliação da mortalidade cirúrgica em aneurismas infra-renais da aorta abdominal. J Vasc Bras.. 2002;1:15-21.

Carvalho FC, Brito VPMR, Tribulatto EC, Bellen BV. Estudo prospectivo da morbi-mortalidade precoce e tardia da cirurgia do aneurisma da aorta abdominal. Arq Bras Cardiol.. 2005;84:292-6.

Mendonça CT, Moreira RCR, Timi JRR. Comparação entre os tratamentos aberto e endovascular dos aneurismas da aorta abdominal em pacientes de alto risco cirúrgico. J Vasc Bras.. 2005;4:232-42.

Suggested standards for reports dealing with lower extremity ischemia. J Vasc Surg.. 1986;4:80-94.

Illig KA, Green RM, Ouriel K, Riggs P, Bartos S, DeWeese JA. Fate of the proximal aortic cuff: implications for endovascular aneurysm repair. J Vasc Surg.. 1997;26:492-9.

Kalman PG, Rappaport DC, Merchant N, Clarke K, Johnston KW. The value of late computed tomographic scanning identification of vascular abnormalities after abdominal aortic aneurysm repair. J Vasc Surg.. 1999;29:442-50.

May J, White GH, Waugh R. Improved survival after endoluminal repair with second-generation prostheses compared with open repair in the treatment of abdominal aortic aneurysms: A 5-year concurrent comparison using life table method. J Vasc Surg.. 2001;33(2^sSuppl):S21-6.

Luccas GC, Lobato AC, Menezes FH. Superior mesenteric artery syndrome: An uncommon complication of abdominal aortic aneurysm repair. Ann Vasc Surg.. 2004;18:250-3.

Ballard JL, Abou-Zamzam AM, Teruya TH, Bianchi C, Petersen FF. Quality of life before and after endovascular and retroperitoneal abdominal aortic aneurysm repair. J Vasc Surg.. 2004;39:797-803.

Soulez G, Thérasse E, Monfared AA. Endovascular versus open repair of abdominal aortic aneurysms in patients at low risk. J Vasc Interv Radiol.. 2005;16:1093-100.

Aljabri B, Al Wahaibi K, Abner D. Patient-reported quality of life after abdominal aortic aneurysm surgery: A prospective comparison of endovascular and open repair. J Vasc Surg.. 2006;44:1182-7.

Menard MT, Nguyen LL, Chan RK. Thoracovisceral segment aneurysm repair after previous infrarenal abdominal aortic aneurysm surgery. J Vasc Surg.. 2004;39:1163-70.

Matsumura JS, Chaikof EL. Continued expansion of aortic necks after endovascular repair of abdominal aortic aneurysms: EVT Investigators. EndoVascular Technologies, Inc. J Vasc Surg.. 1998;28:422-30.

Makaroun MS, Deaton DH. Is proximal aortic neck dilatation after endovascular aneurysm exclusion a cause for concern?. J Vasc Surg.. 2001;33(2^sSuppl):S39-45.

Prinssen M, Wever JJ, Mali WP, Eikelboom BC, Blankensteijn JD. Concerns for the durability of the proximal abdominal aortic aneurysm endograft fixation from a 2-year and 3-year longitudinal computed tomography angiography study. J Vasc Surg.. 2001;33(2^sSuppl):S64-9.

Waasdorp EJ, de Vries JP, Hobo R. Aneurysm diameter and proximal aortic neck diameter influence clinical outcome of endovascular abdominal aortic repair: A 4-year EUROSTAR experience. Ann Vasc Surg.. 2005;19:755-61.

Litwinski RA, Donayre CE, Chow SL. The role of aortic neck dilation and elongation in the etiology of stent graft migration after endovascular abdominal aortic aneurysm repair with a passive fixation device. J Vasc Surg.. 2006;44:1176-81.

Liapis C, Kakisis J, Kaperonis E. Changes of the infrarenal aortic segment after conventional abdominal aortic aneurysm repair. Eur J Vasc Endovasc Surg.. 2000;19:643-7.

Baker DM, Hinchliffe RJ, Yusuf SW, Whitaker SC, Hopkinson BR. True Juxta-anastomotic aneurysms in the residual infra-renal abdominal aorta. Eur J Vasc Endovasc Surg.. 2003;25:412-5.

Hassen-Khodja R, Feugier P, Favre JP, Nevelsteen A, Ferreira J. University Association for Research in Vascular Surgery: Outcome of common iliac arteries after straight aortic tube-graft placement during elective repair of infrarenal abdominal aortic aneurysms. J Vasc Surg.. 2006;44:943-8.

Carpenter JP, Baum RA, Barker CF. Durability of benefits of endovascular versus conventional abdominal aortic aneurysm repair. J Vasc Surg.. 2002;35:222-8.

Gioia LC, Filion KB, Haider S, Pilote L, Eisenberg MJ. Hospital readmissions following abdominal aortic aneurysm repair. Ann Vasc Surg.. 2005;19:35-41.

Dion YM, Gracia CR, Ben El Kadi HH. Totally laparoscopic abdominal aortic aneurysm repair. J Vasc Surg.. 2001;33:181-5.

Dion YM, Griselli F, Douville Y, Langis P. Early and mid-term results of totally laparoscopic surgery for aortoiliac disease: Lessons learned. Surg Laparosc Endosc Percutan Tech.. 2004;14:328-34.

Kolvenbach R, Schwierz E, Wasilljew S, Miloud A, Puerschel A, Pinter L. Total laparoscopically and robotically assisted aortic aneurysm surgery: a critical evaluation. J Vasc Surg.. 2004;39:771-6.

Kolvenbach R, Pinter L, Raghunandan M, Cheshire N, Ramadan H, Dion YM. Laparoscopic remodeling of abdominal aortic aneurysms after endovascular exclusion: a technical description. J Vasc Surg.. 2002;36:1267-70.

Kolvenbach R, Lin J. Combining laparoscopic and endovascular techniques to improve the outcome of aortic endografts: Hybrid techniques. J Cardiovasc Surg. 2005;46:415-23.

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