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. 2022 Apr 4;92(2):222-229.
doi: 10.24875/ACM.21000077.

[Five-year outcomes of elective infrarenal abdominal aortic aneurysm repair at a university hospital in Argentina]

[Article in Spanish]
Ignacio M Bluro  1 , Fernando Garagoli  1 , Norberto B Fiorini  1 , José M Rabellino  2 , José G Chas  2 , Alberto Domenech  3 , Vadim Kotowicz  3 , Rodolfo Pizarro  1
Affiliations

[Five-year outcomes of elective infrarenal abdominal aortic aneurysm repair at a university hospital in Argentina]

[Article in Spanish]
Ignacio M Bluro et al. Arch Cardiol Mex. .

Abstract
in English, Spanish

Objective: Few data about outcomes of elective infrarenal abdominal aortic aneurysm (AAA) repair in Latin America have been published. The objective of the present study is to address this aspect in our population.

Method: Retrospective cohort, in which patients with infrarenal AAA undergoing elective surgical or endovascular repair from January 2011 to May 2017 at a university hospital in Autonomous City of Buenos Aires were consecutively included. The primary endpoints were perioperative mortality and all-cause mortality during follow-up. Among the secondary endpoints, the requeriment of reinterventions was assessed.

Results: 195 patients were included. Open surgery was performed in 72 patients (36.9%) and endovascular aortic repair (EVAR) in 123 (63.1%). Perioperative mortality in the surgery group was 2.8%, while no deaths were recorded in the endovascular group (p = 0.06). The median follow-up was 38 months. No statistically significant difference was found in long-term mortality incidence rate between patients who underwent EVAR and those who underwent open surgery (7% per year vs. 6.7% per year, p = 0.8). The requirement of reinterventions was significantly higher in the endovascular group (9.0% vs. 0%, p = 0.01).

Conclusions: Survival analyses demonstrated no statistically significant differences in perioperative and long-term mortality for patients who underwent EVAR compared with those who underwent open surgery, while the former had a higher rate of reinterventions. The results observed in our population do not differ from those published in the United State or Europe.

Ojetivo: La evidencia surgida en Latinoamérica acerca de los resultados de la reparación electiva del aneurisma de aorta abdominal (AAA) es escasa, por lo que el objetivo de este estudio es abordar este aspecto en la población nacional.

Método: Cohorte retrospectiva en la cual se incluyó de forma consecutiva a pacientes con AAA infrarrenal sometidos a reparación quirúrgica o endovascular en forma electiva desde enero de 2011 hasta mayo de 2017 en un hospital universitario de la Ciudad Autónoma de Buenos Aires. Los puntos finales primarios fueron la mortalidad perioperatoria y la mortalidad por todas las causas durante el seguimiento. Entre los puntos finales secundarios se evaluó el requerimiento de reintervenciones.

Resultados: Se incluyó a 195 pacientes. La operación abierta se llevó a cabo en 72 pacientes (36.9%), mientras que el procedimiento endovascular se practicó en 123 (63.1%). La mortalidad perioperatoria en el grupo quirúrgico fue de 2.8%, sin registro de muertes en el grupo endovascular (p = 0.06). La mediana de seguimiento fue de 38 meses. La incidencia de mortalidad tardía fue de 7%/año en pacientes con reparación endovascular y de 6.7%/año en los quirúrgicos (p = 0.8). El requerimiento de reintervenciones fue significativamente mayor en el grupo endovascular (9.0% vs. 0%, p = 0.01).

Conclusiones: La mortalidad perioperatoria y la mortalidad tardía de los pacientes tratados de manera electiva por AAA en forma quirúrgica o endovascular fueron similares, en tanto que los pacientes sometidos a reparación endovascular requirieron mayor cantidad de reintervenciones. Los resultados observados en la población no difieren de los publicados en Estados Unidos o Europa.

Keywords: Aneurysm; Abdominal aorta; EVAR; Open surgery.

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Conflict of interest statement

Ninguno.

Figures

Figura 1
Figura 1
Duración de la estadía hospitalaria (en días) según el tipo de reparación del aneurisma de la aorta abdominal (AAA).
Figura 2
Figura 2
Curva de sobrevida de Kaplan-Meier de pacientes sometidos a reparación electiva de AAA infrarrenal en forma endovascular o quirúrgica. AAA: aneurisma de aorta abdominal; EVAR: reparación endovascular de aorta.
Figura 3
Figura 3
Curva de sobrevida sin reintervenciones en pacientes sometidos a reparación electiva de AAA infrarrenal en forma endovascular o quirúrgica. AAA: aneurisma de aorta abdominal; EVAR: reparación endovascular de aorta.
Figura 4
Figura 4
Número de angiotomografías solicitadas por cada paciente en todo el seguimiento y sus hallazgos. TC: tomografía computarizada.
Figura 5
Figura 5
Algoritmo propuesto para el seguimiento de pacientes con endoprótesis aórtica. EVAR: reparación endovascular de aorta; AngioTC: angiotomografía computarizada.
See this image and copyright information in PMC

References

    1. Erbel R, Aboyans V, Boileau C, Bossone E, Bartolomeo RD, Eggebrecht H, et al. 2014 ESC Guidelines on the diagnosis and treatment of aortic diseases:Document covering acute and chronic aortic diseases of the thoracic and abdominal aorta of the adult. The Task Force for the Diagnosis and Treatment of Aortic Diseases of the European Society of Cardiology (ESC) Eur Heart J. 2014;35:2873–926. - PubMed
    1. Kent K, Zwolak R, Egorova N. Analysis of risk factors for abdominal aortic aneurysm in a cohort of more than 3 million individuals. J Vasc Surg. 2010;52:539–48. - PubMed
    1. Parodi JC, Palmaz JC, Barone HD. Transfemoral intraluminal graft implantation for abdominal 230 aortic aneurysms. Annals of Vascular Surgery. 1991;5:491–9. - PubMed
    1. Prinssen M, Verhoeven EL, Buth J, Cuypers PW, van Sambeek MR, Balm R, et al. Dutch Randomized Endovascular Aneurysm Management (DREAM) Trial Group. A randomized trial comparing conventional and endovascular repair of abdominal aortic aneurysms. N Engl J Med. 2004;351:1607–18. - PubMed
    1. Greenhalgh RM, Brown LC, Kwong GP, Powell JT, Thompson SG EVAR Trial Participants. Comparison of endovascular aneurysm repair with open repair in patients with abdominal aortic aneurysm (EVAR trial 1), 30-day operative mortality results:randomised controlled trial. Lancet. 2004;364:843–8. - PubMed