Tratamento endovascular versus tratamento aberto de aneurisma de artéria poplítea: artigo de revisão
Endovascular vs. open repair of popliteal artery aneurysm: review article
Rodrigo Nóbrega Bandeira, Daniel Guimarães Cacione, Francisco Chavier Vieira Bandeira, Ariane de Sousa Pelissoni, Cibele Ohany Nogueira Leite, Luis Carlos Uta Nakano
Resumo
O tratamento convencional do aneurisma da artéria poplítea é a cirurgia aberta de exclusão do aneurisma e revascularização do membro acometido. Nos últimos anos, o tratamento endovascular vem ganhando popularidade e interesse. O tratamento endovascular é menos invasivo e de menor morbidade; porém, é de alto custo e sua perviedade é incerta. O objetivo desta revisão é comparar os dois tratamentos através da análise de desfechos abordados em estudos primários e secundários. Realizou-se uma revisão narrativa da literatura publicada nos últimos 5 anos. Foram selecionados seis estudos retrospectivos, duas metanálises, um ensaio clínico e uma revisão sistemática Cochrane. Número limitado de pacientes e curto período de seguimento não nos permitem extrair conclusões consistentes. Não há evidência clara que sugere melhores resultados entre um ou outro tratamento eletivo. Novos ensaios randomizados devem ser realizados para determinar o papel do tratamento endovascular desse aneurisma.
Palavras-chave
Abstract
The conventional treatment for a popliteal artery aneurysm is open surgery to exclude the aneurysm and revascularization of the affected limb. Over recent years, endovascular treatment has grown in popularity and has been attracting increased interest. Endovascular treatment is less invasive and associated with lower rates of morbidity, but it is expensive and patency is uncertain. The aim of this review is to compare these two treatments by analyzing the outcomes reported in primary and secondary studies. A narrative review is conducted of the literature published over the last 5 years. Six retrospective studies, two meta-analyses, one clinical trial and one Cochrane systematic review were selected. We were unable to draw firm conclusions because of small patient samples and short follow-up periods. There is no clear evidence to indicate that the outcomes of one or another elective treatment are superior. New randomized trials should be conducted to determine the role endovascular treatment has to play in management of this type of aneurysm.
Keywords
References
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