Prospective cohort 20 years after endovascular treatment for abdominal aortic aneurysm
Prospective cohort 20 years after endovascular treatment for abdominal aortic aneurysm
Data
2018
Autores
Espinosa, Gaudencio
di Luccio, Giovanni
Alves, Marcia Ribeiro
Gutfilen, Bianca
Raggio, Ronir
Saad, Pedro
Dzieciuchowicz, Lukasz
Magliano, Carlos
Journal Title
Journal ISSN
Volume Title
Publisher
Journal of Vascular Surgery
Resumo
Objective: To describe the factors associated with survival 20 years after endovascular treatment of an abdominal aortic
aneurysm (AAA) in a single center.
Methods: Prospective cohort of asymptomatic patients with an infrarenal aortic aneurysm treated with a bifurcated
endovascular graft (Talent) between June 1997 and August 2008. Cox proportional hazard multivariable regression was
used for analysis of independent risk factors for survival. Kaplan-Meier curves were done with the long-rank test. P < .05
was considered significant.
Results: We followed 229 patients, 184 without an endoleak and 45 with an endoleak. Ages ranged between 52 and
89 years, and the mean diameter of the aneurysm was 59.51 6 14.6 mm. Implantation of the endovascular graft was
possible in 99% of the patients. The 30-day mortality rate was 3.4%. In the Cox regression, age <73 years (hazard ratio [HR],
0.42; 95% confidence interval [CI], 0.27-0.64), aneurysm size #55 mm (HR, 0.62; 95% CI, 0.40-0.95), male sex (HR, 0.17; 95%
CI, 0.05-0.52), American Society of Anesthesiologists surgical risk category I and II vs III and IV (HR, 0.51; 95% CI, 0.34-0.75),
and aneurysm size reduction #3 mm after treatment (HR, 2.23; 95% CI, 1.11-4.51) were significantly correlated with the
survival of the patients followed in this long-term case series.
Conclusions: This 20-year prospective cohort included patients with an AAA treated with a bifurcated endovascular graft
(Talent) at a university hospital in Brazil. This study supports that sex, age, aneurysm size, aneurysm size reduction, and
American Society of Anesthesiologists surgical risk category are significantly correlated with patient survival after
endovascular treatment of the AAA. (J Vasc Surg 2018;67:1102-9.)
Description
Palavras-chave
Age factors, Aged, Aged, 80 and over, Aortic Aneurysm, Abdominal / diagnostic imaging, Aortic Aneurysm, Abdominal / mortality, Aortic Aneurysm, Abdominal / surgery*, Blood Vessel Prosthesis, Blood Vessel Prosthesis Implantation* / adverse effects, Blood Vessel Prosthesis Implantation* / instrumentation, Blood Vessel Prosthesis Implantation* / mortality, Brazil, Cause of Death, Endoleak / etiology, Endovascular Procedures* / adverse effects, Endovascular Procedures* / instrumentation, Endovascular Procedures* / mortality, Female, Hospitals, University, Humans, Kaplan-Meier Estimate, Male, Middle Aged, Multivariate Analysis, Proportional Hazards Models, Prosthesis Design, Retrospective Studies, Risk Factors, Sex Factors, Time Factors, Treatment Outcome
Citação
Espinosa G, di Luccio G, Alves MR, Gutfilen B, Raggio R, Saad P, Dzieciuchowicz L, Magliano C. Prospective cohort 20 years after endovascular treatment for abdominal aortic aneurysm. J Vasc Surg. 2018 Apr;67(4):1102-1109. doi: 10.1016/j.jvs.2017.08.063.