[Outcomes of endoprosthetic repair of abdominal aortic aneurysm].

Autor:	Popova IV; Cardiosurgical Department of Vascular Pathology and Hybrid Technologies, Centre of Vascular and Hybrid Surgery, Meshalkin National Medical Research Centre of the RF Ministry of Public Health, Novosibirsk, Russia., Ignatenko PV; Cardiosurgical Department of Vascular Pathology and Hybrid Technologies, Centre of Vascular and Hybrid Surgery, Meshalkin National Medical Research Centre of the RF Ministry of Public Health, Novosibirsk, Russia., Rabtsun AA; Cardiosurgical Department of Vascular Pathology and Hybrid Technologies, Centre of Vascular and Hybrid Surgery, Meshalkin National Medical Research Centre of the RF Ministry of Public Health, Novosibirsk, Russia., Saaia SB; Cardiosurgical Department of Vascular Pathology and Hybrid Technologies, Centre of Vascular and Hybrid Surgery, Meshalkin National Medical Research Centre of the RF Ministry of Public Health, Novosibirsk, Russia., Bugurov SV; Cardiosurgical Department of Vascular Pathology and Hybrid Technologies, Centre of Vascular and Hybrid Surgery, Meshalkin National Medical Research Centre of the RF Ministry of Public Health, Novosibirsk, Russia., Soborov MA; Department of Hospital Surgery, Sechenov First Moscow State Medical University of the RF Ministry of Public Health, Moscow, Russia., Popov VV; Department of Surgical Diseases, Novosibirsk National Research State University, Novosibirsk, Russia., Diusupov AA; Department of Cardiovascular and Thoracic Surgery, Semey Medical University, Semey, Kazakhstan., Karpenko AA; Cardiosurgical Department of Vascular Pathology and Hybrid Technologies, Centre of Vascular and Hybrid Surgery, Meshalkin National Medical Research Centre of the RF Ministry of Public Health, Novosibirsk, Russia.
Jazyk:	ruština
Zdroj:	Angiologiia i sosudistaia khirurgiia = Angiology and vascular surgery [Angiol Sosud Khir] 2021; Vol. 27 (4), pp. 59-69.
DOI:	10.33529/ANGIO2021402
Abstrakt:	Aim: The study was aimed at assessing efficacy and safety of endovascular treatment of abdominal aortic aneurysms based on 11-year experience with implantation of stent grafts. Patients and Methods: We retrospectively analysed outcomes of treatment of 242 patients with abdominal aortic aneurysm during the period from 2008 to 2019. Of these, 210 (86.78%) were males, mean age 69.32±7.36 years. Diagnosis was made using colour duplex scanning and contrast-enhanced multislice spiral computed tomography, with implanting the following stent grafts: Ella - 44, Ovation Prime - 33, Anaconda - 13, Endurand - 77, Aortix - 2, Zenith - 33, Seal - 39, with one endoprosthesis placement failed. Assessing safety of the operation, we took into consideration lethality due to aortic rupture/thrombosis. Efficacy was taken to mean technical success of the operation (implantation of all components of the endograft without switch to open surgery), the number of reoperations. Results: Technical success of the operation was achieved in 98.35% of cases. In 1 case due to pronounced arterial calcification for technical reasons we failed to position the stent graft and in another case - the contralateral leg of the Ella prosthesis. The early postoperative period revealed: type A1 endoleak - 3.7%, type IB - 4.13%, type IIA - 6.6%, type IIB - 4.54%, type III - 0.83%, type IV - 0.83%. Repeat operations were performed in 20 (8.2%) patients within 30 days after the intervention and in 32 (13.22%) in the remote period. In the early postoperative period two conversions were performed: 1) iliorenal bypass grafting for restoration of blood flow through the renal artery occluded by endoprosthesis wall; 2) evacuation of retroperitoneal haematoma due to rupture of the common femoral artery. Lethality during the whole period of follow up amounted to 32 (13.22%) cases. Of these, due to aortic complications 4.54% (n=11) and due to accompanying pathology 8.67% (n=21). A direct correlation was revealed between the aortic diameter and duration of the operation which in turn increases the risk of complications requiring re-operation or resulting in a lethal outcome (RR - 1; 95% CD 1- 1; p=0.026). Conclusion: Our experience showed high safety and efficacy of stent graft implantation in treatment of patients with abdominal aortic aneurysms and high surgical risk.
Databáze:	MEDLINE
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