AAA Endo Rev Med Chile

Rev Méd Chile 2006; 134: 1265-1274

Tratamiento endovascular de
aneurisma aórtico abdominal:
resultados en 80 pacientes
consecutivos
Francisco Valdés E, Renato Mertens M,
Albrecht Krämer Sch, Michel Bergoeing R,
Leopoldo Mariné M, Roberto Canessa Be1,
Alvaro Huete G2, Jeanette Vergara Ga,
Magaly Valdebenito C3, Dixiana Rivera D3,a.

Endovascular repair of abdominal
aortic aneurysm. Results in 80consecutive patients
Background: Endovascular r epair of abdominal aortic aneurysms
(AAA) avoids laparotomy, shortens hospital stay and r educes morbidity and mortality related to
surgical repair, allowing full patient recovery in less time. Aim: To report short and long term results of
endovascular repair of AAA in 80 consecutive patients treated at our institution. Patients and
Methods: BetweenSeptember 1997 and February 2005, three women and 77 men with a mean age
73.67.7 years with AAA 5.81.0 cm in diameter, were treated. The surgical risk of 38% of patients was
grade III according to the American Society of Anesthesiologists classification. Each procedure was
per for med in the operating r oom, under local or r egional anesthesia, with the aid of digital
substraction angiography.The endograft was deployed through the femoral artery (83.7% bifurcated,
16.3% tubular graft). A femoro-femoral bypass was required in 11.3% of cases. Follow up included a
spiral CT scan at 1, 6 and 12 months postoperatively, and then annually. Results: Endovascular
repair was successfully completed in 79/80 patients (98.7% technical success). The procedures lasted
14771 min. Length of stay in theobservation unit was 20.613.5 hrs. Blood transfusion was required
in 10%. Sixty two percent of the patients were discharged before 72 h. One patient died 8 days after
surgery due to a myocardial infarction (1.3%). During follow up (3-90 months), 1 patient developed
late AAA enlargement due to a type I endoleak, requiring a new endograft. No AAA rupture was
observed. Survival at 4 years was 84.2%(SE =9.2). Endovascular re-intervention free survival was
82.7% (SE =9.5). Conclusion: Endovascular surgery allows effective exclusion of AAA avoiding
progressive enlargement and/or rupture and is a good alternative to open repair. Close and frequent
postoperative follow up is mandatory (Rev Méd Chile 2006; 134: 1265-74).
(Key words: Aortic aneurysm; Blood vessel prosthesis; Or gan grafts;Transplants)
Recibido el 11 de octubre, 2005. Aceptado el 3 de abril, 2006.
Cirugía Vascular y Endovascular, Departamento de Enfermedades Cardiovasculares y División
de Cirugía. 1Anestesia Cardiovascular, Departamento de Anestesiología. 2Imagenología
Cardiovascular, Departamento de Radiología, Facultad de Medicina y Hospital Clínico,
Pontificia Universidad Católica de Chile. 3Instituto Vascular deSantiago.
aEnfermera Universitaria

C o rr e s p o n d e n c i a a : Dr. Francisco Valdés E. Cirugía
Vascular y Endovascular, Hospital Clínico y Facultad de
Medicina, Pontificia Universidad Católica de Chile.
Marcoleta 367 6º piso. Fono (56-2) 686-3268. Fax (56-2)
632 6812. E mail: franval@med.puc.cl

A
I

R T Í C U L O

D E

N V E S T I G A C I Ó N

1265

Rev Méd Chile 2006; 134: 1265-1274

E

n 1990Parodi desarrolló y aplicó exitosamen
te una técnica mínimamente invasiva para el
tratamiento del aneurisma aórtico abdominal
(AAA), en la que insertando una prótesis a través
de las arterias femorales, se excluye efectivamente
el AAA de la circulación, se evita una laparotomía
y se elimina el riesgo de ruptura1. Desde entonces, dicha técnica se ha perfeccionado, difundido
universalmente, ytransformado rápidamente en
una alternativa para pacientes que presentan una
anatomía compatible, especialmente si son considerados de alto riesgo para la cirugía convencional2,3. Nuestra experiencia inicial con esta técnica
fue reportada en 19984.
El objetivo del presente trabajo es analizar la
efectividad del tratamiento del AAA por vía endovascular, su morbilidad, durabilidad y la sobrevida...