Kulig Piotr, Lewandowski Krzysztof, Rudel Bogusław, Chwała Maciej, Piwowarczyk Marek, Mrowiecki Wojciech
Department of Vascular Surgery and Angiology, Brothers of Mercy St. John of God Hospital, Krakow, Poland.
Department of Internal Medicine and Angiology, Brothers of Mercy St. John of God Hospital, Krakow, Poland.
Wideochir Inne Tech Maloinwazyjne. 2021 Mar;16(1):191-198. doi: 10.5114/wiitm.2020.93984. Epub 2020 Mar 27.
The endovascular method as a less invasive treatment for patients with abdominal aortic aneurysm (AAA) has become an alternative to conventional open surgery.
The objective of the present study was to analyse the outcomes of endovascular treatment of AAA patients in long-term observation.
A group of 236 AAA patients subjected to planned endovascular aneurysm repair (EVAR) between 2010 and 2015 was reviewed. Rates of mortality, surgical complications and re-interventions were collected in the separate time periods, i.e. up to 30 days after surgery, 30 days to 3 years, and from 3 to 5 years after surgery. Cumulative rates of these parameters were evaluated in the short-term (up to 30 days after surgery), medium-term (up to 3 years), and long-term (up to 5 years after surgery) perspective.
The median age of patients was 75 years, and the most common comorbidities were arterial hypertension (54%) and ischaemic heart disease (52%). Cumulative short-, medium- and long-term mortality rates were 2.5%, 14.2% and 28.9%, respectively. Total rates of surgical complications in short-, medium- and long-term observation were 7.6%, 12.6% and 17.5%, respectively. The cumulative rate of re-interventions ranged from 4.2% to 11.4%.
In the consecutive time periods, the increase in the percentage of surgical complications and re-interventions increased gradually, in contrast to mortality, where the curve grew significantly, which is expected due to the aging and numerous comorbidities in the observed group of patients.
血管内治疗作为腹主动脉瘤（AAA）患者侵入性较小的治疗方法，已成为传统开放手术的替代方案。
本研究的目的是分析腹主动脉瘤患者血管内治疗的长期观察结果。
回顾了2010年至2015年间接受计划性血管内动脉瘤修复（EVAR）的236例腹主动脉瘤患者。在不同时间段收集死亡率、手术并发症和再次干预率，即术后30天内、30天至3年以及术后3至5年。从短期（术后30天内）、中期（至3年）和长期（术后5年）的角度评估这些参数的累积率。
患者的中位年龄为75岁，最常见的合并症是动脉高血压（54%）和缺血性心脏病（52%）。短期、中期和长期的累积死亡率分别为2.5%、14.2%和28.9%。短期、中期和长期观察中的手术并发症总发生率分别为7.6%、12.6%和17.5%。再次干预的累积率在4.2%至11.4%之间。
在连续的时间段内，手术并发症和再次干预的百分比逐渐增加，与死亡率相反，死亡率曲线显著上升，这是由于观察组患者的老龄化和众多合并症所致。
