Jornal Vascular Brasileiro
https://www.jvascbras.org/article/doi/10.1590/1677-5449.008817
Jornal Vascular Brasileiro
Review Article

Comparação entre cirurgia aberta e endovascular no tratamento do aneurisma da artéria poplítea: uma revisão

Comparison of open and endovascular surgery for treatment of popliteal artery aneurysm: a review

Ana Fernanda Fagundes Gonçalves, Carlos Augusto Pelek, Lorena Slusarz Nogueira, Renan Francisco de Carvalho, Matheo Augusto Morandi Stumpf, Ricardo Zanetti Gomes, Ana Claudia Garabeli Cavalli Kluthcovsky

Downloads: 1
Views: 1203

Resumo

Os aneurismas de artéria poplítea correspondem a 70% dos aneurismas periféricos e o tratamento é cirúrgico, com controvérsias sobre os resultados da via endovascular. Este estudo objetivou realizar uma revisão da literatura sobre a comparação entre cirurgia aberta e endovascular no tratamento dos aneurismas da artéria poplítea. A pesquisa foi realizada utilizando os termos apropriados nos portais de periódicos LILACS e MEDLINE, com a seleção de 15 artigos. Um total de 5.166 procedimentos cirúrgicos foram comparados, sendo 3.930 cirurgias abertas e 1.236 cirurgias endovasculares. A cirurgia aberta com bypass venoso continua sendo o padrão-ouro. A cirurgia endovascular apresenta menor tempo de internação e é uma opção viável em pacientes eletivos, com baixa expectativa de vida, alto risco cirúrgico, comorbidades e mais idosos, desde que tenham anatomia favorável para o procedimento. Contudo, são necessários estudos de longo prazo para estabelecer os reais benefícios e indicações das duas técnicas, como o ensaio clínico randomizado controlado.

Palavras-chave

aneurisma; artéria poplítea; procedimentos endovasculares.

Abstract

Popliteal artery aneurysms account for 70% of peripheral aneurysms and must be treated surgically. The results of endovascular treatment are controversial. The objective of this study is to conduct a literature review on comparisons between open surgery and endovascular treatment for popliteal artery aneurysms. Searches were run on the LILACS and MEDLINE databases using the appropriate search terms and 15 articles were selected. A total of 5,166 surgical procedures were compared, 3,930 open surgeries and 1,236 endovascular surgeries. Open surgery with venous bypass is still the gold standard. Endovascular surgery offers shorter length of hospital stay and is a viable option for elective patients, those with short life expectancy, high surgical risk, comorbidities, and more advanced age. However, long-term studies are needed to establish the true benefits and indications for the two techniques, such as randomized clinical trials.

Keywords

aneurysm; popliteal artery; endovascular procedures.

References

1. Maffei FHA, Lastória S, Yoshida WB, Rollo HA, Giannini M, Moura R. Doenças vasculares periféricas. 4. ed. Rio de Janeiro: Guanabara Koogan; 2008. p. 1311-1318. cap. 70.

2. Hall HA, Minc S, Babrowski T. Peripheral artery aneurysm. Surg Clin North Am. 2013;93(4):911-23, ix. http://dx.doi.org/10.1016/j.suc.2013.04.008. PMid:23885937.

3. Galizia MS, Ward E, Rodriguez H, Collins J, Carr J. Improved characterization of popliteal aneurysms using gadofosveset-enhanced equilibrium phase magnetic resonance angiography. J Vasc Surg. 2013;57(3):837-41. http://dx.doi.org/10.1016/j.jvs.2012.09.018. PMid:23294506.

4. Phair A, Hajibandeh S, Hajibandeh S, Kelleher D, Ibrahim R, Antoniou GA. Meta-analysis of posterior versus medial approach for popliteal artery aneurysm repair. J Vasc Surg. 2016;64(4):1141-50. http://dx.doi.org/10.1016/j.jvs.2016.05.064. PMid:27473776.

5. Jarraya M, Simmons S, Farber A, Teytelboym O, Naggara N, Guermazi A. Uncommon diseases of the popliteal artery: a pictorial review. Insights Imaging. 2016;7(5):679-88. http://dx.doi.org/10.1007/s13244-016-0513-6. PMid:27525419.

6. Joshi D, James RL, Jones L. Endovascular versus open repair of asymptomatic popliteal artery aneurysm. Cochrane Database Syst Rev. 2014;31(8):CD010149. PMid:25173678.

7. Brito CJ, Duque A, Merlo I, Murilo R, Filho VL. Cirurgia vascular. 2. ed. Rio de Janeiro: Revinter; 2008. p. 1339-1350. cap. 91, vol. 2.

8. Santos CMC, Pimenta CAM, Nobre MRC. A estratégia PICO para a construção da pergunta de pesquisa e busca de evidências. Rev. Latino-Am. Enfermagem. 2007;15(3):508-11. http://dx.doi.org/10.1590/S0104-11692007000300023.

9. Braga AFF, Catto RC, Ribeiro MS, Piccinato CE, Joviliano EE. Cirurgia aberta e endovascular no tratamento de aneurisma de artéria poplítea: experiência de cinco anos do HCRP-FMRP-USP. J Vasc Bras. 2015;14(4):297-304. http://dx.doi.org/10.1590/1677-5449.02715.

10. Wooster M, Back M, Gaeto H, Shames M. Late longitudinal comparison of endovascular and open popliteal aneurysm repairs. Ann Vasc Surg. 2016;30:253-7. http://dx.doi.org/10.1016/j.avsg.2015.07.012. PMid:26365111.

11. Eslami MH, Rybin D, Doros G, Farber A. Open repair of asymptomatic popliteal artery aneurysm is associated with better outcomes than endovascular repair. J Vasc Surg. 2015;61(3):663-9. http://dx.doi.org/10.1016/j.jvs.2014.09.069. PMid:25454212.

12. Serrano Hernando FJ, Martínez López I, Hernández Mateo MM, et al. Comparison of popliteal artery aneurysm therapies. J Vasc Surg. 2015;61(3):655-61. http://dx.doi.org/10.1016/j.jvs.2014.10.007. PMid:25499705.

13. Huang Y, Gloviczki P, Oderich GS, et al. Outcomes of endovascular and contemporary open surgical repairs of popliteal artery aneurysm. J Vasc Surg. 2014;60(3):631-8.e2. http://dx.doi.org/10.1016/j.jvs.2014.03.257. PMid:24768361.

14. Cervin A, Tjärnström J, Ravn H, et al. Treatment of popliteal aneurysm by open and endovascular surgery: a contemporary study of 592 procedures in Sweden. Eur J Vasc Endovasc Surg. 2015;50(3):342-50. http://dx.doi.org/10.1016/j.ejvs.2015.03.026. PMid:25911500.

15. Pulli R, Dorigo W, Fargion A, et al. Comparison of early and midterm results of open and endovascular treatment of popliteal artery aneurysms. Ann Vasc Surg. 2012;26(6):809-18. http://dx.doi.org/10.1016/j.avsg.2011.09.005. PMid:22321483.

16. Pulli R, Dorigo W, Castelli P, et al. A multicentric experience with open surgical repair and endovascular exclusion of popliteal artery aneurysms. Eur J Vasc Endovasc Surg. 2013;45(4):357-63. http://dx.doi.org/10.1016/j.ejvs.2013.01.012. PMid:23391602.

17. Galiñanes EL, Dombrovskiy VY, Graham AM, Vogel TR. Endovascular versus open repair of popliteal artery aneurysms: outcomes in the US Medicare population. Vasc Endovascular Surg. 2013;47(4):267-73. http://dx.doi.org/10.1177/1538574413475888. PMid:23393086.

18. Leake AE, Avgerinos ED, Chaer RA, Singh MJ, Makaroun MS, Marone LK. Contemporary outcomes of open and endovascular popliteal artery aneurysm repair. J Vasc Surg. 2016;63(1):70-6. http://dx.doi.org/10.1016/j.jvs.2015.08.056. PMid:26474505.

19. Curi MA, Geraghty PJ, Merino AO, et al. Mid-term outcomes of endovascular popliteal artery aneurysm repair. J Vasc Surg. 2007;45(3):505-10. http://dx.doi.org/10.1016/j.jvs.2006.09.064. PMid:17275247.

20. Ronchey S, Pecoraro F, Alberti V, et al. Popliteal artery aneurysm repair in the endovascular era: fourteen-years single center experience. Medicine. 2015;94(30):e1130. http://dx.doi.org/10.1097/MD.0000000000001130. PMid:26222843.

21. Stone PA, Jagannath P, Thompson SN, et al. Evolving treatment of popliteal artery aneurysms. J Vasc Surg. 2013;57(5):1306-10. http://dx.doi.org/10.1016/j.jvs.2012.10.122. PMid:23375437.

22. Antonello M, Frigatti P, Battocchio P, et al. Open repair versus endovascular treatment for asymptomatic popliteal artery aneurysm: results of a prospective randomized study. J Vasc Surg. 2005;42(2):185-93. http://dx.doi.org/10.1016/j.jvs.2005.04.049. PMid:16102611.

23. Antonello M, Frigatti P, Battocchio P, et al. Endovascular treatment of asymptomatic popliteal aneurysms: 8-year concurrent comparison with open repair. J Cardiovasc Surg. 2007;48(3):267-74. PMid:17505429.

24. Clinical Trial. Open Versus Endovascular Repair of Popliteal Artery Aneurysm Trial (OVERPAR) [Internet]. 2017. [citado 2017 ago 6]. Disponível em: https://clinicaltrials.gov/ct2/show/NCT01817660

Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)"> Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)">
5cd2cffb0e88252354632f90 jvb Articles

J Vasc Bras

Share this page
Page Sections