Karakişi Sedat Ozan, Ergene Şaban, Hemşinli Doğuş, Küçüker Şeref Alp
Department of Cardiovascular Surgery, Recep Tayyip Erdoğan University, Faculty of Medicine, Rize, Turkey.
Department of Cardiovascular Surgery, Yıldırım Beyazıt University Training and Research Hospital, Ankara, Turkey.
Turk Gogus Kalp Damar Cerrahisi Derg. 2019 Jan 1;27(1):29-34. doi: 10.5606/tgkdc.dergisi.2019.16328. eCollection 2019 Jan.
In this study, we present our early and mid-term results of endovascular aneurysm repair in patients with infrarenal abdominal aortic aneurysms.
Between December 2011 and January 2017, a total of 154 patients (136 males, 18 females; mean age 71.7 years; range, 55 to 94 years) who underwent endovascular aneurysm repair were retrospectively analyzed. Data including demographic characteristics of the patients, pre-procedural additional diagnoses, mortality and morbidity rates, length of intensive care unit and hospital stays, amounts of blood products used, complications and reinterventions were recorded.
Seven patients underwent intervention in the emergency setting due to aneurysm rupture, while 147 patients received elective surgery. The mean follow-up was 35 (range, 12 to 72) months, the mean length of intensive care unit stay was 1.1 (range, 1 to 4) days, and the mean length of hospital stay was 3.1 (range, 3 to 7) days. A mean 0.3 units of erythrocyte suspension was used during the treatment. Endoleak developed in 16 patients, occlusion in the graft leg in two patients, increased aneurysmal diameter in six patients, and wound healing problems in five patients. Cross femoral bypass was applied in two patients, balloon dilation in three patients, proximal extension in three patients, and distal extension in four patients. Intraoperative mortality occurred in one patient. The total mortality rate was 7% and first 30-day mortality rate was 2%.
Our study results suggest that endovascular aneurysm repair has certain advantages including a low operative mortality rate, short intensive care unit and hospital stays, and less blood product use. In addition, this technique can be performed with regional anesthesia in high-risk comorbid patients.
在本研究中，我们展示了肾下腹主动脉瘤患者血管内动脉瘤修复术的早期和中期结果。
回顾性分析2011年12月至2017年1月期间共154例行血管内动脉瘤修复术的患者（136例男性，18例女性；平均年龄71.7岁；范围55至94岁）。记录的数据包括患者的人口统计学特征、术前额外诊断、死亡率和发病率、重症监护病房和住院时间、血液制品使用量、并发症和再次干预情况。
7例患者因动脉瘤破裂在急诊情况下接受干预，147例患者接受择期手术。平均随访时间为35（范围12至72）个月，重症监护病房平均住院时间为1.1（范围1至4）天，平均住院时间为3.1（范围3至7）天。治疗期间平均使用0.3单位红细胞悬液。16例患者出现内漏，2例患者移植物肢体闭塞，6例患者动脉瘤直径增大，5例患者伤口愈合问题。2例患者行股动脉交叉搭桥术，3例患者行球囊扩张术，3例患者行近端延伸术，4例患者行远端延伸术。1例患者术中死亡。总死亡率为7%，30天内首次死亡率为2%。
我们的研究结果表明，血管内动脉瘤修复术具有一定优势，包括手术死亡率低、重症监护病房和住院时间短、血液制品使用量少。此外，该技术可在高危合并症患者中采用区域麻醉进行。
