Levent YILIK, Ali GÜRBÜZ, Serkan YAZMAN, Barçın ÖZCEM, Hasan İNER, Tevfik GÜNEŞ, Ufuk YETKİN, İsmail YÜREKLİ

Our mid-term results of endovascular repair of abdominal aortic aneurysms

Amaç: Bu çalışmada abdominal aort anevrizmalarının endovasküler tamirinde orta dönem sonuçlarımız bildirildi.Ça lış ma pla nı: Ocak 2006-Aralık 2013 tarihleri arasında abdominal aort anevrizması yırtığı nedeniyle elektif veya acil endovasküler aort tamiri yapılan toplam 203 hasta (187 erkek, 16 kadın; ort. yaş 69.1±8.8 yıl; dağılım 38-89 yıl) retrospektif olarak incelendi. Mortalite, morbidite, sağkalım oranları, ortalama ameliyat süresi, ortalama mekanik ventilasyon süresi, ortalama yoğun bakım ünitesinde ve hastanede kalış süresi, kaçak tipi ve insidansı, kontrast nefropati oranları, çıplak metal uçlu stent greftlerin kullanımı ve aort çapının kaçak üzerindeki etkileri, komplikasyon oranları ve ikincil girişim oranları kaydedildi. Mortalite oranları ve yaşam kalitesi aynı zaman dilimi içinde açık cerrahi ile karşılaştırıldı.Bul gu lar: Gruplar arasında mortalite oranları açısından anlamlı bir fark yoktu. Sonuçlar kısa dönemde endovasküler aort tamiri lehine olmakla birlikte, yaşam kalitesi açısından uzun dönemde anlamlı bir fark gözlenmedi.So nuç: Endovasküler aort tamiri, abdominal aort anevrizmalı ve eşlik eden hastalığı ve yüksek mortalite riski olan hastalarda bir tedavi seçeneği olabilir. Çalışma sonuçlarımıza göre, EVAR tedavisinde komplikasyon ve ikincil girişim oranları stent greft teknolojisinin gelişmesi, cerrahın deneyimi ve uygun anatomili hastaların seçilmesi ile azaltılabilir.

Abdominal aort anevrizmalarının endovasküler tamirinde orta dönem sonuçlarımız

Background: This study aims to report our mid-term results of endovascular repair of abdominal aortic aneurysms.Methods: Between January 2006 and December 2013, a total of 203 patients (187 males, 16 females; mean 69.1±8.8 years; range 38 to 89 years) who underwent endovascular aortic repair electively or emergently due to a ruptured abdominal aortic aneurysm were retrospectively analyzed. Mortality, morbidity, survival rates, mean duration of operation, mean duration of mechanical ventilation, mean length of intensive care unit and hospital stays, the type and incidence of endoleaks, contrast nephropathy rates, effects of use of stent grafts with bare-metal tips and aortic diameter on endoleak, complication rates, and secondary intervention rates were recorded. The mortality rates and quality of life were compared with that of open surgery within the same period of time.Results: There was no significant difference in the mortality rates between the groups. No significant difference was observed in the quality of life in the long-term, although the results were in favor of endovascular aortic repair in short-term.Conclusion: Endovascular aortic repair can be selected as a treatment option in abdominal aortic aneurysm patients with co-morbidities and high mortality risk. Based on our study results, the rates of complication and secondary intervention in EVAR treatment can be reduced with improved stent graft technology, operator experience, and selection of patients with suitable anatomy.

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