IBD/IBE VS. HYPOGASTRIC ARTERY EMBOLIZATION — HOW TO CHOOSE AND WHAT’S THE OUTCOME?
Autor(a) principal: | |
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Data de Publicação: | 2020 |
Outros Autores: | , , , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | por |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | https://doi.org/10.48750/acv.254 |
Resumo: | Introduction: There is no standard anatomic or clinical criteria guiding treatment modalities of iliac aneurysms. The main endovascular options are hypogastric artery endovascular exclusion or hypogastric preservation with iliac branch devices (IBD) or iliac branch endoprosthesis (IBE). However, outcomes of each technique are not clear yet. Methods: An observational retrospective study was designed. Patients who underwent EVAR + IBD/IBE (Group 1) or EVAR + hypogastric artery embolization (Group 2) on a tertiary hospital, from January 2016 to April 2019, were included. Data were collected from medical records. Primary endpoint was procedure-related complications (intra-operative complications; type 1 and 3 endoleaks; EVAR limb occlusions; pelvic, intestinal and spinal cord ischemia; gluteal claudication; procedure-related mortality). Secondary endpoints were hospitalization duration, type 2 endoleaks, freedom from reintervention and global survival. Results: 30 patients were included. 19 underwent elective IBD/IBE due to asymptomatic aneurysm; 11 underwent hypogastric artery embolization, 5 of them in emergency. Mean age was lower in Group 1 (69,79 ±8,30 years vs. 75,73±6,15 years in Group 2; p=0,049). Technical success was 100%. There was no significant difference in procedure-related complications (Group 1: 21%; Group 2: 36%; p=0,417); we found similar rates of mortality and EVAR limb occlusions. The difference in incidence of gluteal claudication was non-significant (30% in Group 2 vs. 7% in Group 1; p=0,267). Freedom from reintervention was similar in both groups (Group 1: 84%, Group 2: 83%; p=0,827). Global survival at two years was similar (Group 1: 89,5±0,7%; Group 2: 87,5±1,2%; p=0,935). Conclusion: Both procedures are safe and effective and, nowadays, its individualized selection is mostly determined by procedure cost and urgency. |
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IBD/IBE VS. HYPOGASTRIC ARTERY EMBOLIZATION — HOW TO CHOOSE AND WHAT’S THE OUTCOME?IBD/IBE VS. EMBOLIZAÇÃO DA ARTÉRIA HIPOGÁSTRICA — COMO DECIDIR E QUAL O PROGNÓSTICO?Aorto-Iliac AneurysmHypogastric Artery EmbolizationHypogastric Artery PreservationIliac Branch Device (IDB)Iliac Branch Endoprosthesis (IBE)Aneurisma Aorto-IlíacoEmbolização da Artéria HipogástricaPreservação da Artéria HipogástricaIliac Branch Device (IDB)Iliac Branch Endoprosthesis (IBE)Introduction: There is no standard anatomic or clinical criteria guiding treatment modalities of iliac aneurysms. The main endovascular options are hypogastric artery endovascular exclusion or hypogastric preservation with iliac branch devices (IBD) or iliac branch endoprosthesis (IBE). However, outcomes of each technique are not clear yet. Methods: An observational retrospective study was designed. Patients who underwent EVAR + IBD/IBE (Group 1) or EVAR + hypogastric artery embolization (Group 2) on a tertiary hospital, from January 2016 to April 2019, were included. Data were collected from medical records. Primary endpoint was procedure-related complications (intra-operative complications; type 1 and 3 endoleaks; EVAR limb occlusions; pelvic, intestinal and spinal cord ischemia; gluteal claudication; procedure-related mortality). Secondary endpoints were hospitalization duration, type 2 endoleaks, freedom from reintervention and global survival. Results: 30 patients were included. 19 underwent elective IBD/IBE due to asymptomatic aneurysm; 11 underwent hypogastric artery embolization, 5 of them in emergency. Mean age was lower in Group 1 (69,79 ±8,30 years vs. 75,73±6,15 years in Group 2; p=0,049). Technical success was 100%. There was no significant difference in procedure-related complications (Group 1: 21%; Group 2: 36%; p=0,417); we found similar rates of mortality and EVAR limb occlusions. The difference in incidence of gluteal claudication was non-significant (30% in Group 2 vs. 7% in Group 1; p=0,267). Freedom from reintervention was similar in both groups (Group 1: 84%, Group 2: 83%; p=0,827). Global survival at two years was similar (Group 1: 89,5±0,7%; Group 2: 87,5±1,2%; p=0,935). Conclusion: Both procedures are safe and effective and, nowadays, its individualized selection is mostly determined by procedure cost and urgency.Introdução: No tratamento dos aneurismas ilíacos, não estão definidos critérios clínicos e anatómicos que guiem a decisão entre as duas principais modalidades terapêuticas endovasculares (exclusão endovascular da artéria hipogástrica com extensão da endoprótese para a artéria ilíaca externa ou preservação hipogástrica com iliac branch devices (IBD) ou iliac branch endoprosthesis (IBE)) e desconhece-se o seu impacto no prognóstico do doente. Métodos: Estudo observacional retrospetivo realizado com base na consulta de processos clínicos de doentes submetidos a EVAR com IBD/IBE (Grupo 1) ou EVAR com embolização de hipogástrica (Grupo 2), num hospital terciário, de Janeiro de 2016 a Abril de 2019. O endpoint primário foi a taxa de complicações relacionadas com o procedimento (complicações intra-operatórias, endoleaks tipo 1 e 3, oclusão de ramo de EVAR, isquémia pélvica, intestinal ou medular, claudicação glútea e mortalidade relacionada com o procedimento) e os secundários foram o tempo de internamento, a taxa de endoleaks tipo 2, a taxa de reintervenção vascular e a sobrevida global. Resultados: A amostra incluiu 30 doentes. 19 foram submetidos a IBD/IBE eletivamente por aneurisma assintomático e 11 a embolização da hipogástrica, dos quais 5 em contexto de urgência. A média de idades do Grupo 1 (69,79 ±8,30 anos) foi estatisticamente inferior à Grupo 2 (75,73±6,15 anos; p=0,049). A taxa de sucesso técnico foi de 100%. Não houve diferença estatisticamente significativa entre os dois grupos no que respeita à taxa de complicações relacionadas com o procedimento (21% no Grupo 1 e 36% no Grupo 2; p=0,417), com taxas sobreponíveis de mortalidade e de oclusão de ramo de EVAR. Não houve diferença estatisticamente significativa na taxa de claudicação glútea entre os grupos (30% no Grupo 2 vs. 7% no Grupo 1; p=0,267). A sobrevida livre de reintervenção vascular foi sobreponível entre os grupos (Grupo 1: 84%, Grupo 2: 83%; p=0,827) e a sobrevida global aos dois anos foi semelhante (Grupo 1: 89,5±0,7%; Grupo 2: 87,5±1,2%; p=0,935). Conclusão: Ambos os procedimentos são seguros e eficazes e a sua seleção individualizada é atualmente maioritariamente determinada pelo custo e urgência do procedimento.Sociedade Portuguesa de Angiologia e Cirurgia Vascular2020-04-30T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttps://doi.org/10.48750/acv.254oai:ojs.acvjournal.com:article/254Angiologia e Cirurgia Vascular; Vol. 16 No. 1 (2020): March; 3-10Angiologia e Cirurgia Vascular; Vol. 16 N.º 1 (2020): Março; 3-102183-00961646-706Xreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPporhttp://acvjournal.com/index.php/acv/article/view/254https://doi.org/10.48750/acv.254http://acvjournal.com/index.php/acv/article/view/254/167Copyright (c) 2020 Angiologia e Cirurgia Vascularinfo:eu-repo/semantics/openAccessCorreia, RicardoGarcia, AnaCamacho, NelsonCatarino, JoanaBento, RitaPais, FábioVieira, IsabelGarcia, RitaFerreira, RitaGonçalves, FredericoFerreira, Maria Emília2022-05-23T15:10:07Zoai:ojs.acvjournal.com:article/254Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T14:57:38.012169Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
IBD/IBE VS. HYPOGASTRIC ARTERY EMBOLIZATION — HOW TO CHOOSE AND WHAT’S THE OUTCOME? IBD/IBE VS. EMBOLIZAÇÃO DA ARTÉRIA HIPOGÁSTRICA — COMO DECIDIR E QUAL O PROGNÓSTICO? |
title |
IBD/IBE VS. HYPOGASTRIC ARTERY EMBOLIZATION — HOW TO CHOOSE AND WHAT’S THE OUTCOME? |
spellingShingle |
IBD/IBE VS. HYPOGASTRIC ARTERY EMBOLIZATION — HOW TO CHOOSE AND WHAT’S THE OUTCOME? Correia, Ricardo Aorto-Iliac Aneurysm Hypogastric Artery Embolization Hypogastric Artery Preservation Iliac Branch Device (IDB) Iliac Branch Endoprosthesis (IBE) Aneurisma Aorto-Ilíaco Embolização da Artéria Hipogástrica Preservação da Artéria Hipogástrica Iliac Branch Device (IDB) Iliac Branch Endoprosthesis (IBE) |
title_short |
IBD/IBE VS. HYPOGASTRIC ARTERY EMBOLIZATION — HOW TO CHOOSE AND WHAT’S THE OUTCOME? |
title_full |
IBD/IBE VS. HYPOGASTRIC ARTERY EMBOLIZATION — HOW TO CHOOSE AND WHAT’S THE OUTCOME? |
title_fullStr |
IBD/IBE VS. HYPOGASTRIC ARTERY EMBOLIZATION — HOW TO CHOOSE AND WHAT’S THE OUTCOME? |
title_full_unstemmed |
IBD/IBE VS. HYPOGASTRIC ARTERY EMBOLIZATION — HOW TO CHOOSE AND WHAT’S THE OUTCOME? |
title_sort |
IBD/IBE VS. HYPOGASTRIC ARTERY EMBOLIZATION — HOW TO CHOOSE AND WHAT’S THE OUTCOME? |
author |
Correia, Ricardo |
author_facet |
Correia, Ricardo Garcia, Ana Camacho, Nelson Catarino, Joana Bento, Rita Pais, Fábio Vieira, Isabel Garcia, Rita Ferreira, Rita Gonçalves, Frederico Ferreira, Maria Emília |
author_role |
author |
author2 |
Garcia, Ana Camacho, Nelson Catarino, Joana Bento, Rita Pais, Fábio Vieira, Isabel Garcia, Rita Ferreira, Rita Gonçalves, Frederico Ferreira, Maria Emília |
author2_role |
author author author author author author author author author author |
dc.contributor.author.fl_str_mv |
Correia, Ricardo Garcia, Ana Camacho, Nelson Catarino, Joana Bento, Rita Pais, Fábio Vieira, Isabel Garcia, Rita Ferreira, Rita Gonçalves, Frederico Ferreira, Maria Emília |
dc.subject.por.fl_str_mv |
Aorto-Iliac Aneurysm Hypogastric Artery Embolization Hypogastric Artery Preservation Iliac Branch Device (IDB) Iliac Branch Endoprosthesis (IBE) Aneurisma Aorto-Ilíaco Embolização da Artéria Hipogástrica Preservação da Artéria Hipogástrica Iliac Branch Device (IDB) Iliac Branch Endoprosthesis (IBE) |
topic |
Aorto-Iliac Aneurysm Hypogastric Artery Embolization Hypogastric Artery Preservation Iliac Branch Device (IDB) Iliac Branch Endoprosthesis (IBE) Aneurisma Aorto-Ilíaco Embolização da Artéria Hipogástrica Preservação da Artéria Hipogástrica Iliac Branch Device (IDB) Iliac Branch Endoprosthesis (IBE) |
description |
Introduction: There is no standard anatomic or clinical criteria guiding treatment modalities of iliac aneurysms. The main endovascular options are hypogastric artery endovascular exclusion or hypogastric preservation with iliac branch devices (IBD) or iliac branch endoprosthesis (IBE). However, outcomes of each technique are not clear yet. Methods: An observational retrospective study was designed. Patients who underwent EVAR + IBD/IBE (Group 1) or EVAR + hypogastric artery embolization (Group 2) on a tertiary hospital, from January 2016 to April 2019, were included. Data were collected from medical records. Primary endpoint was procedure-related complications (intra-operative complications; type 1 and 3 endoleaks; EVAR limb occlusions; pelvic, intestinal and spinal cord ischemia; gluteal claudication; procedure-related mortality). Secondary endpoints were hospitalization duration, type 2 endoleaks, freedom from reintervention and global survival. Results: 30 patients were included. 19 underwent elective IBD/IBE due to asymptomatic aneurysm; 11 underwent hypogastric artery embolization, 5 of them in emergency. Mean age was lower in Group 1 (69,79 ±8,30 years vs. 75,73±6,15 years in Group 2; p=0,049). Technical success was 100%. There was no significant difference in procedure-related complications (Group 1: 21%; Group 2: 36%; p=0,417); we found similar rates of mortality and EVAR limb occlusions. The difference in incidence of gluteal claudication was non-significant (30% in Group 2 vs. 7% in Group 1; p=0,267). Freedom from reintervention was similar in both groups (Group 1: 84%, Group 2: 83%; p=0,827). Global survival at two years was similar (Group 1: 89,5±0,7%; Group 2: 87,5±1,2%; p=0,935). Conclusion: Both procedures are safe and effective and, nowadays, its individualized selection is mostly determined by procedure cost and urgency. |
publishDate |
2020 |
dc.date.none.fl_str_mv |
2020-04-30T00:00:00Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://doi.org/10.48750/acv.254 oai:ojs.acvjournal.com:article/254 |
url |
https://doi.org/10.48750/acv.254 |
identifier_str_mv |
oai:ojs.acvjournal.com:article/254 |
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por |
language |
por |
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http://acvjournal.com/index.php/acv/article/view/254 https://doi.org/10.48750/acv.254 http://acvjournal.com/index.php/acv/article/view/254/167 |
dc.rights.driver.fl_str_mv |
Copyright (c) 2020 Angiologia e Cirurgia Vascular info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
Copyright (c) 2020 Angiologia e Cirurgia Vascular |
eu_rights_str_mv |
openAccess |
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application/pdf |
dc.publisher.none.fl_str_mv |
Sociedade Portuguesa de Angiologia e Cirurgia Vascular |
publisher.none.fl_str_mv |
Sociedade Portuguesa de Angiologia e Cirurgia Vascular |
dc.source.none.fl_str_mv |
Angiologia e Cirurgia Vascular; Vol. 16 No. 1 (2020): March; 3-10 Angiologia e Cirurgia Vascular; Vol. 16 N.º 1 (2020): Março; 3-10 2183-0096 1646-706X reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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RCAAP |
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RCAAP |
reponame_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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