Jornal Vascular Brasileiro
https://jvascbras.org/article/doi/10.1590/S1677-54492008000100007
Jornal Vascular Brasileiro
Original Article

Tratamento endovascular de aneurisma de artéria poplítea

Endovascular treatment of popliteal artery aneurysm

Fernando Thomazinho; Jose Manoel da Silva Silvestre; Wander Eduardo Sardinha; Fernando Motta; Igor Schincariol Perozin; Domingos de Morais Filho

Downloads: 0
Views: 792

Resumo

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.

Palavras-chave

Aneurisma periférico, aneurisma da artéria poplítea, tratamento endovascular

Abstract

BACKGROUND: The most commonly occurring aneurysms in the periphery are those involving the popliteal artery. They comprise 70-80% of all such aneurysms. Conventional aneurysm repair consists of either opening the aneurysm sac and interposing a bypass graft or aneurysm ligation combined with bypass grafting. Endovascular treatment is an alternative to conventional repair. OBJECTIVE: To evaluate use of stent graft in the endovascular treatment of popliteal artery aneurysms. METHODS: We analyzed 17 male patients; of these, 11 were treated with endovascular stent graft, using Hemobahn and Viabahn stent grafts. RESULTS: One patient had pseudoaneurysm in the immediate postoperative period. Among late complications, one patient had distal endoleak after 7 months, and there was stent graft occlusion in another patient. The remaining nine patients had satisfactory Doppler ultrasonography control at 20 months, which resulted in a primary patency of 90% over mean follow-up time of 27 months. CONCLUSION: Endovascular repair of a popliteal artery aneurysm is feasible and has some advantages compared with the open treatment, such as shorter hospital stay and recovery.

Keywords

Peripheral aneurysms, popliteal artery aneurysm, endovascular treatment

References

Antonello M, Frigatti P, Battocchio P. Open repair versus endovascular treatment for asymptomatic popliteal artery aneurysm: results of a prospective randomized study. J Vasc Surg. 2005;42:185-93.

Lowell RC, Gloviczki P, Hallett JW Jr. Popliteal artery aneurysms: the risk of nonoperative management. Ann Vasc Surg. 1994;8:14-23.

Dawson I, van Bockel JH, Brand R, Terpstra JL. Popliteal artery aneurysms: long term follow-up of aneurysmal disease and results of surgical treatment. J Vasc Surg. 1991;13:398-407.

Roggo A, Brunner U, Ottinger LW, Largiader F. The continuing challenge of aneurysms of the popliteal artery. Surg Gynecol Obstet. 1993;177:565-72.

Galego GN, Silveira PG, Bacega NR. Apresentação clínica e tratamento cirúrgico na doença aneurismática da artéria poplítea. Angiol Cir Vasc. 2002;11:119-25.

Morris-Stiff G, Haynes M, Ogunbiyi S. Is assessment of popliteal artery diameter in patients undergoing screening for abdominal aortic aneurysms a worthwhile procedure. Eur J Vasc Endovasc Surg. 2005;30:71-4.

Ebaugh JL, Matsumura JS, Morasch MD, Pearce WH, Nemcek AA, Yao JS. Morphometric analysis of the popliteal artery for endovascular treatment. Vasc Endovascular Surg. 2003;37:23-6.

Kauffman P, Puech-Leão P. Tratamento cirúrgico do aneurisma da artéria poplítea: experiência de 32 anos. J Vasc Bras. 2002;1:5-14.

Dawson I, Sie RB, van Bockel JH. Atherosclerotic poplíteal aneurysm. Br J Surg. 1997;84:293-9.

Elsman BH, van Rijn AB. In-situ saphenous vein bypass graft for popliteal artery aneurysm. Neth J Surg. 1991;43:14-6.

Galland RB, Magee TR. Management of popliteal aneurysm. Br J Surg. 2002;89:1382-5.

Szilagyi DE, Schwartz RL, Reddy DJ. Popliteal arterial aneurysms. Arch Surg. 1981;116:724-8.

Jones WT, Hagino RT, Chiou AC, Decaprio JD, Franklin KS, Kashyap VS. Graft patency is not the only clinical predictor of success after exclusion and bypass of popliteal artery aneurysms. J Vasc Surg. 2003;37:392-8.

Sarcina A, Bellosta R, Luzzani L, Agrifoglio G. Surgical treatment of popliteal artery aneurysm: A 20 year experience. J Cardiovasc Surg (Torino). 1997;38:347-54.

Borowicz MR, Robison JG, Elliott BM, Brothers TE, Robinson CK. Occlusive disease associated with popliteal aneurysms: impact on long term graft patency. J Cardiovasc Surg (Torino). 1998;39:137-40.

Huang Y, Gloviczki P, Noel AA. Early complications and long-term outcomes after open surgical treatment of popliteal artery aneurysms: Is exclusion with saphenous vein bypass still the gold standard?. J Vasc Surg. 2007;45:706-13.

Shortell CK, DeWeese JA, Ouriel K. Popliteal artery aneurysms: a 25-year surgical experience. J Vasc Surg. 1991;14:771-9.

Carpenter JP, Barker CF, Roberts B, Berkowitz HD, Lusk EJ, Perloff LJ. Popliteal artery aneurysms: current management and outcome. J Vasc Surg. 1994;19:65-73.

Marin M, Veith FJ, Panetta TF. Transfemoral endoluminal stented graft repair of a popliteal artery aneurysm. J Vasc Surg. 1994;19:754-7.

Medeiros CAF, Gaspar RJ. Correção endovascular do aneurisma de artéria poplítea bilateral. J Vasc Bras. 2006;5:303-7.

Howell M, Krajcer Z, Diethrich EB. Wallgraft endoprosthesis for the percutaneous treatment of femoral and popliteal artery aneurysms. J Endovasc Ther. 2002;9:76-81.

Tielliu IF, Verhoeven EL, Zeebregts CJ, Prins TR, Span MM, van den Dungen JJ. Endovascular treatment of popliteal artery aneurysms: results of a prospective cohort study. J Vasc Surg. 2005;41:561-7.

Aulivola B, Hamdan AD, Hile CN. Popliteal artery aneurysm: a comparison of outcomes in elective versus emergent repair. J Vasc Surg. 2004;39:1171-7.

Curi MA, Geraghty PJ, Merino OA. Mid-term outcomes of endovascular popliteal artery aneurysm repair. J Vasc Surg. 2007;45:505-10.

Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)"> Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)">
5ddd75330e8825d6061da3e9 jvb Articles

J Vasc Bras

Share this page
Page Sections