Nuri KARABAY, Yiğit GÖKTAY, Erdem SİLİSTRELİ, Özalp KARABAY, Aytaç GÜLCÜ, Kemal KARAARSLAN, Yusuf KUSERLİ, Cenk ERDAL

Abdominal aort anevrizmalarının endovasküler tedavisi sonrası derin ven trombozu insidansı

Amaç: Bu çalışmada abdominal aort anevrizması (AAA) olan hastalarda endovasküler stent-greft (EVSG) tedavisi sonrasında gelişen derin ven trombozu (DVT) sıklığı araştırıldı. Çalışma planı: Ocak 2005 - Nisan 2011 tarihleri arasında, kliniğimizde EVSG işlemi ile tedavi edilen 114 AAA’lı hasta (109 erkek, 5 kadın; ort. 69.6 yıl; dağılım 43-92 yıl), prospektif olarak incelendi. Hastalar DVT gelişimi açısından, işlem sonrasında 10. günde ve 3. ayda renkli Doppler ultrasonografi ve fizik muayene ile izlendi. Bulgular: Endovasküler stent-greft uygulanan hastaların ikisinde (%1.75) DVT gelişti. Sonuç: Abdominal aort anevrizması olan hastalar ameliyat sonrası DVT gelişimi açısından yüksek riskli olmalarına rağmen, bu sıklık EVSG tedavisinde düşük olarak saptandı.

The incidence of deep venous thrombosis after endovascular stent-graft treatment of abdominal aortic aneurysms

Background: In this study, we aimed to establish the incidence of deep venous thrombosis (DVT) after endovascular stent-graft (EVSG) treatment of abdominal aortic aneurysms (AAA). Methods: Between January 2005 - April 2011, 114 patients (109 males; 5 females; mean age 69.6 years; range 43 to 92 years) who underwent EVSG treatment of AAA in our clinic were prospectively evaluated. Patients were monitored for the development of DVT on day 13 and at three months through color Doppler ultrasonography and physical examination. Results: Two patients (1.75%) developed DVT after EVSG treatment. Conclusion: Although patients who undergo surgical treatment of AAA are at high-risk for the development of DVT, the incidence of DVT associated with EVSG treatment is found to be low.

PDF

___

1. Lovegrove RE, Javid M, Magee TR, Galland RB. A meta-analysis of 21,178 patients undergoing open or endovascular repair of abdominal aortic aneurysm. Br J Surg 2008;95:677-84.
2. Kearon C. Natural history of venous thromboembolism. Circulation 2003;107(23 Suppl 1):I22-30.
3. Passman MA, Farber MA, Marston WA, Carlin RE, Owens LV, Burnham CB, et al. Prospective screening for postoperative deep venous thrombosis in patients undergoing infrainguinal revascularization. J Vasc Surg 2000;32:669-75.
4. de Maistre E, Terriat B, Lesne-Padieu AS, Abello N, Bouchot O, Steinmetz EF. High incidence of venous thrombosis after surgery for abdominal aortic aneurysm. J Vasc Surg 2009;49:596-601.
5. Silverstein MD, Heit JA, Mohr DN, Petterson TM, O’Fallon WM, Melton LJ 3rd. Trends in the incidence of deep vein thrombosis and pulmonary embolism: a 25-year populationbased study. Arch Intern Med 1998;158:585-93.
6. White RH. The epidemiology of venous thromboembolism. Circulation 2003;107(23 Suppl 1):I4-8.
7. Gutt CN, Oniu T, Wolkener F, Mehrabi A, Mistry S, Büchler MW. Prophylaxis and treatment of deep vein thrombosis in general surgery. Am J Surg 2005;189:14-22.
8. Proctor MC, Greenfield LJ. Pulmonary embolism: diagnosis, incidence and implications. Cardiovasc Surg 1997;5:77-81.
9. Sandler DA, Martin JF. Autopsy proven pulmonary embolism in hospital patients: are we detecting enough deep vein thrombosis? J R Soc Med 1989;82:203-5.
10. Zurawska U, Parasuraman S, Goldhaber SZ. Prevention of pulmonary embolism in general surgery patients. Circulation 2007;115:e302-7.
11. Lewis CE Jr, Mueller C, Edwards WS. Venous stasis on the operating table. Am J Surg 1972;124:780-4.
12. Comerota AJ, Stewart GJ, Alburger PD, Smalley K, White JV. Operative venodilation: a previously unsuspected factor in the cause of postoperative deep vein thrombosis. Surgery 1989;106:301-8.
13. Coleridge-Smith PD, Hasty JH, Scurr JH. Venous stasis and vein lumen changes during surgery. Br J Surg 1990;77:1055-9.
14. Hansson PO, Welin L, Tibblin G, Eriksson H. Deep vein thrombosis and pulmonary embolism in the general population. ‘The Study of Men Born in 1913’. Arch Intern Med 1997;157:1665-70.
15. White RH. The epidemiology of venous thromboembolism. Circulation 2003;107(23 Suppl 1):I4-8.
16. Eagleton MJ, Grigoryants V, Peterson DA, Williams DM, Henke PK, Wakefield TW, et al. Endovascular treatment of abdominal aortic aneurysm is associated with a low incidence of deep venous thrombosis. J Vasc Surg 2002;36:912-6.
17. Bush RL, Lumsden AB, Dodson TF, Salam AA, Weiss VJ, Smith RB 3rd, et al. Mid-term results after endovascular repair of the abdominal aortic aneurysm. J Vasc Surg 2001;33(2 Suppl):S70-6.
18. Moore WS, Brewster DC, Bernhard VM. Aorto-uni-iliac endograft for complex aortoiliac aneurysms compared with tube/bifurcation endografts: results of the EVT/Guidant trials. J Vasc Surg 2001;33(2 Suppl):S11-20.
19. Hendolin H, Mattila MA, Poikolainen E. The effect of lumbar epidural analgesia on the development of deep vein thrombosis of the legs after open prostatectomy. Acta Chir Scand 1981;147:425-9.
20. Jaffer AK, Barsoum WK, Krebs V, Hurbanek JG, Morra N, Brotman DJ. Duration of anesthesia and venous thromboembolism after hip and knee arthroplasty. Mayo Clin Proc 2005;80:732-8.
21. Agnelli G. Prevention of venous thromboembolism in surgical patients. Circulation 2004;110(24 Suppl 1):IV4-12.
22. Hollyoak M, Woodruff P, Muller M, Daunt N, Weir P. Deep venous thrombosis in postoperative vascular surgical patients: a frequent finding without prophylaxis. J Vasc Surg 2001;34:656-60.
23. Samama CM, Albaladejo P, Benhamou D, Bertin-Maghit M, Bruder N, Doublet JD, et al. Venous thromboembolism prevention in surgery and obstetrics: clinical practice guidelines. Eur J Anaesthesiol 2006;23:95-116.