Jornal Vascular Brasileiro
https://www.jvascbras.org/article/doi/10.1590/1677-5449.200087
Jornal Vascular Brasileiro
Original Article

The outcomes of internal iliac artery preservation during endovascular or open surgery treatment for aortoiliac aneurysms

Os resultados da preservação da artéria ilíaca interna durante o tratamento endovascular ou em cirurgia aberta para aneurismas aorto-ilíacos

Rafael de Athayde Soares; Marcelo Fernando Matielo; Francisco Cardoso Brochado Neto; Amanda Thurler Palomo; Rodrigo Andrade Lourenço; Caroline Tanaka; Roberto Sacilotto

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Abstract

Abstract: Background: Internal iliac artery (IIA) preservation continues to be a challenge during open surgery or endovascular repair of abdominal aortoiliac aneurysm (AAIA).

Objectives: 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.

Methods: This was a retrospective consecutive cohort study of patients with AAIA who underwent EV or OS repair.

Results: 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).

Conclusions: 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.

Keywords

endovascular surgery, aortic aneurysm, iliac aneurysm, aortoiliac open surgery

Resumo

Resumo: Contexto: A preservação de uma artéria ilíaca interna continua a ser um desafio terapêutico nos pacientes com aneurismas aorto-ilíacos submetidos tanto ao tratamento endovascular quanto a cirurgia aberta.

Objetivos: Determinar os resultados da sobrevida e desfechos clínicos em pacientes com aneurismas aorto-ilíacos (AAIA) que recebem reparo endovascular (EV) ou cirúrgico aberto (CA).

Métodos: Este foi um estudo de coorte consecutivo e retrospectivo de pacientes com AAIA submetidos a reparo EV ou CA.

Resultados: Houve maior tempo de internação pós-procedimento e permanência na unidade de terapia intensiva no grupo CA comparado com o grupo EV (7,08±3,5 dias vs. 3,32±2,3 dias; p = 0,03; 3,35±2,2 dias vs. 1,2±0,8 dias; p = 0,02, respectivamente). Houve dois casos de isquemia intestinal (4,7%; CA 8,3% e EV 3,2%; p = 0,48), dois casos de claudicação das nádegas (4,7%; CA 8,3% e EV 3,2%; p = 0,48) e um caso de disfunção sexual (2,3% CA), todos em pacientes com oclusão bilateral da artéria ilíaca interna (AII) (cinco pacientes, 11,6%; p = 0,035). A sobrevida global aos 720 dias foi de 80,6% no grupo EV e de 66,7% no grupo CA (p = 0,58).

Conclusões: No presente estudo, o EV e o CA para aneurismas aorto-ilíacos apresentaram sobrevida e desfechos clínicos semelhantes. A preservação de pelo menos uma AII está associada a bons resultados e sem complicações adicionais.
 

Palavras-chave

cirurgia endovascular, aneurisma aorto-ilíaco, artéria ilíaca interna, cirurgia aberta

References

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Submitted date:
05/30/2020

Accepted date:
07/22/2020

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