Sedat Ozan KARAKİŞİ, Doğuş HEMŞİNLİ, Şaban ERGENE, Şeref Alp KÜÇÜKER

Abdominal aort anevrizmalarının endovasküler tamirine ilişkin erken ve orta dönem sonuçlarımız

Amaç: Bu çalışmada, infrarenal abdominal aort anevrizması olan hastalarda endovasküler anevrizma tamirine ilişkin erken ve orta dönem sonuçlarımız sunuldu. Çalışma planı: Aralık 2011 - Ocak 2017 tarihleri arasında endovasküler anevrizma tamiri yapılan toplam 154 hasta (136 erkek, 18 kadın; ort. yaş 71.7 yıl; dağılım, 55-94 yıl) retrospektif olarak incelendi. Hastaların demografik özellikleri, işlem öncesi ek tanıları, mortalite ve morbidite oranları, yoğun bakım ünitesinde ve hastanede kalış süreleri, kullanılan kan ürünü miktarları, komplikasyonlar ve yeniden girişimler dahil olmak üzere veriler kaydedildi. Bulgular: Yedi hastaya anevrizma rüptürü nedeniyle acil koşullarda girişim uygulanırken, 147 hastaya elektif cerrahi yapıldı. Ortalama takip süresi 35 (dağılım, 12-72) ay, yoğun bakım ünitesinde kalış süresi 1.1 (dağılım, 1-4) gün ve hastanede kalış süresi 3.1 (dağılım, 3-7) gün idi. Tedavi süresince ortalama 0.3 ünite eritrosit süspansiyonu kullanıldı. On altı hastada kaçak, iki hastada greft bacağında tıkanıklık, altı hastada anevrizma çapında artış ve beş hastada yara iyileşme problemi görüldü. İki hastaya kros femoral baypas, üç hastaya balon dilatasyon, üç hastaya proksimal ekstansiyon ve dört hastaya distal ekstansiyon uygulandı. İşlem sırasında bir hastada mortalite gelişti. Total mortalite oranı 7% ve ilk 30 günlük mortalite oranı 2% idi. Sonuç: Çalışma sonuçlarımız endovasküler anevrizma tamirinin düşük cerrahi mortalite oranı, kısa yoğun bakım ünitesi ve hastane yatışı ve daha az kan ürünü kullanımı dahil olmak üzere birtakım avantajlara sahip olduğunu göstermektedir. Ayrıca, bu teknik yüksek riskli komorbid hastalarda rejyonel anestezi ile birlikte gerçekleştirilebilir.

Our early and mid-term results for endovascular repair of abdominal aortic aneurysms

Background: In this study, we present our early and mid-term resultsof endovascular aneurysm repair in patients with infrarenal abdominalaortic aneurysms.Methods: Between December 2011 and January 2017, a total of154 patients (136 males, 18 females; mean age 71.7 years; range,55 to 94 years) who underwent endovascular aneurysm repair wereretrospectively analyzed. Data including demographic characteristicsof the patients, pre-procedural additional diagnoses, mortality andmorbidity rates, length of intensive care unit and hospital stays, amountsof blood products used, complications and reinterventions were recorded.Results: Seven patients underwent intervention in the emergency settingdue to aneurysm rupture, while 147 patients received elective surgery.The mean follow-up was 35 (range, 12 to 72) months, the mean length ofintensive care unit stay was 1.1 (range, 1 to 4) days, and the mean length ofhospital stay was 3.1 (range, 3 to 7) days. A mean 0.3 units of erythrocytesuspension was used during the treatment. Endoleak developed in16 patients, occlusion in the graft leg in two patients, increased aneurysmaldiameter in six patients, and wound healing problems in five patients.Cross femoral bypass was applied in two patients, balloon dilation inthree patients, proximal extension in three patients, and distal extensionin four patients. Intraoperative mortality occurred in one patient. The totalmortality rate was 7% and first 30-day mortality rate was 2%.Conclusion: Our study results suggest that endovascular aneurysmrepair has certain advantages including a low operative mortality rate,short intensive care unit and hospital stays, and less blood product use.In addition, this technique can be performed with regional anesthesia inhigh-risk comorbid patients.

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