Soares Rafael de Athayde, Matielo Marcelo Fernando, Brochado Francisco Cardoso, Palomo Amanda Thurler, Lourenço Rodrigo Andrade, Tanaka Caroline, Sacilotto Roberto
Hospital do Servidor Público Estadual de São Paulo, Serviço de Cirurgia Vascular e Endovascular, São Paulo, SP, Brasil.
J Vasc Bras. 2020 Dec 11;19:e20200087. doi: 10.1590/1677-5449.200087.
Internal iliac artery (IIA) preservation continues to be a challenge during open surgery or endovascular repair of abdominal aortoiliac aneurysm (AAIA).
To determine the results in terms of survival and clinical outcomes in patients with aortoiliac aneurysms (AAIA) treated with endovascular (EV) or open surgical (OS) repair.
This was a retrospective consecutive cohort study of patients with AAIA who underwent EV or OS repair.
Post-procedure hospitalization time and intensive care unit stay were both longer in the OS group than in the EV group (7.08 ± 3.5 days vs. 3.32 ± 2.3 days; p = 0.03; 3.35 ± 2.2 days vs. 1.2 ± 0.8 days; p = 0.02, respectively). There were two cases of bowel ischemia (4.7%; OS 8.3% and EV 3.2%; p = 0.48), two cases of buttock claudication (4.7%; OS 8.3% and EV 3.2%; p = 0.48), and one case of sexual dysfunction (2.3% OS), all of them in patients with bilateral occlusion of the internal iliac artery (five patients, 11.6%; p = 0.035). Overall survival at 720 days was 80.6% in the EV group and 66.7% in the OS group (p = 0.58).
In the present study, OS and EV repair of aortoiliac aneurysms had similar overall survival and outcomes. Preservation of at least one internal iliac artery is associated with good results and no further complications.
在腹主动脉髂动脉瘤（AAIA）的开放手术或血管腔内修复过程中，保留髂内动脉（IIA）仍然是一项挑战。
确定接受血管腔内（EV）或开放手术（OS）修复的腹主动脉髂动脉瘤（AAIA）患者的生存结果和临床结局。
这是一项对接受EV或OS修复的AAIA患者进行的回顾性连续队列研究。
OS组术后住院时间和重症监护病房停留时间均长于EV组（分别为7.08±3.5天对3.32±2.3天；p = 0.03；3.35±2.2天对1.2±0.8天；p = 0.02）。有2例肠缺血（4.7%；OS组8.3%，EV组3.2%；p = 0.48），2例臀部间歇性跛行（4.7%；OS组8.3%，EV组3.2%；p = 0.48），1例性功能障碍（OS组2.3%），所有这些均发生在髂内动脉双侧闭塞的患者中（5例患者，11.6%；p = 0.035）。EV组720天的总生存率为80.6%，OS组为66.7%（p = 0.58）。
在本研究中，腹主动脉髂动脉瘤的OS和EV修复具有相似的总生存率和结局。保留至少一条髂内动脉与良好的结果和无进一步并发症相关。
