Queiroz André Brito, Schneidwind Karina Paula Domingos Rosa, Mulatti Grace Carvajal, Santo Fábio Rodrigues Ferreira Espirito, Sassaki Neto Paulo, Torres Inez Ohashi, De Luccia Nelson
Divisão de Cirurgia Vascular e Endovascular, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil.
Clinics (Sao Paulo). 2014 Jun;69(6):420-5. doi: 10.6061/clinics/2014(06)09.
The aim of this study was to describe our early experience in the treatment of ruptured abdominal aortic aneurysms with bifurcated endografts. We report on our initial twelve-month experience using this approach.
Clinical data on patients with ruptured abdominal aortic aneurysms treated at a single tertiary center in Brazil were prospectively recorded. The eligibility for endovascular treatment was evaluated by computed tomography scanning and anatomical features were determined based on the method of treatment.
From February 2012 to January 2013 (12 months), 28 consecutive patients (mean age 67.2 years, range 45-85 years) underwent treatment for ruptured abdominal aortic aneurysms at our hospital. Eighteen patients (64.3%) were suitable for and underwent endovascular treatment with bifurcated endografts (16 patients) or aortouniiliac endografts (two patients). Ten patients who were considered unsuitable for endograft repair underwent open repair. Seven patients were classified as hemodynamically unstable (Endovascular, 5; Open, 2), and 21 were classified as stable (Endovascular, 13; Open, 8). The overall 30-day mortality rate associated with endovascular treatment was 27.8% (stable, 18.7%; unstable, 40%) and the rate associated with open repair was 50% (stable, 37.5%; unstable, 100%).
In this study, the suitability of patients for endovascular repair of ruptured abdominal aortic aneurysms was high and the overall results of endovascular treatment remain encouraging. Indeed, bifurcated endografts are a feasible option for treating anatomically eligible ruptured abdominal aortic aneurysms.
本研究的目的是描述我们使用分叉型腔内移植物治疗破裂腹主动脉瘤的早期经验。我们报告了采用这种方法最初12个月的经验。
前瞻性记录在巴西一家三级中心接受治疗的破裂腹主动脉瘤患者的临床数据。通过计算机断层扫描评估血管内治疗的适用性，并根据治疗方法确定解剖特征。
从2012年2月至2013年1月（12个月），我院连续28例患者（平均年龄67.2岁，范围45 - 85岁）接受了破裂腹主动脉瘤的治疗。18例患者（64.3%）适合并接受了分叉型腔内移植物（16例患者）或主动脉单髂腔内移植物（2例患者）的血管内治疗。10例被认为不适合腔内修复的患者接受了开放修复。7例患者被分类为血流动力学不稳定（血管内治疗，5例；开放修复，2例），21例被分类为稳定（血管内治疗，13例；开放修复，8例）。血管内治疗相关的30天总死亡率为27.8%（稳定，18.7%；不稳定，40%），开放修复相关的死亡率为50%（稳定，37.5%；不稳定，100%）。
在本研究中，患者适合血管内修复破裂腹主动脉瘤的比例较高，血管内治疗的总体结果仍然令人鼓舞。事实上，分叉型腔内移植物是治疗解剖结构合适的破裂腹主动脉瘤的一种可行选择。
