IMPORTANCE OF AAA SIZE AS A PREDICTOR OF COMPLICATIONS AFTER EVAR

Detalhes bibliográficos
Autor(a) principal: Oliveira-Pinto, José
Data de Publicação: 2020
Outros Autores: Soares-Ferreira, Rita, Oliveira, Nelson, Sousa, Joel, Bastos-Gonçalves, Frederico, Leite-Moreira, Adelino, Mansilha, Armando
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: https://doi.org/10.48750/acv.234
Resumo: Introduction: EVAR represents the preferred modality for Abdominal Aortic Aneurysms (AAA) repair. However, a comprehension regarding its limits is paramount to avoid future complications. AAA sac diameter has been described as a relevant risk factor for late complications. The purpose of this study is to summarize relevant findings regarding the association between AAA diameter and AAA-related complications. Methods: MEDLINE databases were searched to identify data addressing specific information on the relation between AAA sac diameter and incidence of AAA-related complications. Only articles in English language between 2003 and 2019 was included. Primary endpoint was freedom from aneurysm-related complications. Results: Five studies were included in our report, including 8443 patients. In two of the included studies patients with larger AAA sacs were at increased risk for aneurysm-related complications after EVAR (HR 1.02 per mm increase CI95% 1.01–1.04 and HR 1.8 95% CI, 1.20–2.72; P = .005). Two studies reported a higher risk of post implant ruptures (HR: 7.7 CI95% 3.1–18.7;) and late conversions (HR 1.6 CI 95% 1.1–2.3) in patients with AAA diameters over 6 and 6.5 cm, respectively. Finally, one study reported a higher rate of neck-related events in patients with AAA diameter > 65mm [HR: 6.4 (2.3–17.7)]. Conclusion: AAA diameter is a relevant risk factor for late complications. However, research is needed to clarify is these are attributable to the challenging associated anatomy or to the space free of thrombus within the sac. Judicious technique choice along with tailored follow-up strategies are advised in this subgroup of patients.
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spelling IMPORTANCE OF AAA SIZE AS A PREDICTOR OF COMPLICATIONS AFTER EVARDIMENSÃO DO SACO ANEURISMÁTICO COMO PREDITOR DE COMPLICAÇÕES APÓS O EVAREndovascular Aneurysm repairAneurysm sacDiameterOutcomeCorreção endovascular de aneurisma da aorta abdominalSaco aneurismáticoDiâmetroResultadoIntroduction: EVAR represents the preferred modality for Abdominal Aortic Aneurysms (AAA) repair. However, a comprehension regarding its limits is paramount to avoid future complications. AAA sac diameter has been described as a relevant risk factor for late complications. The purpose of this study is to summarize relevant findings regarding the association between AAA diameter and AAA-related complications. Methods: MEDLINE databases were searched to identify data addressing specific information on the relation between AAA sac diameter and incidence of AAA-related complications. Only articles in English language between 2003 and 2019 was included. Primary endpoint was freedom from aneurysm-related complications. Results: Five studies were included in our report, including 8443 patients. In two of the included studies patients with larger AAA sacs were at increased risk for aneurysm-related complications after EVAR (HR 1.02 per mm increase CI95% 1.01–1.04 and HR 1.8 95% CI, 1.20–2.72; P = .005). Two studies reported a higher risk of post implant ruptures (HR: 7.7 CI95% 3.1–18.7;) and late conversions (HR 1.6 CI 95% 1.1–2.3) in patients with AAA diameters over 6 and 6.5 cm, respectively. Finally, one study reported a higher rate of neck-related events in patients with AAA diameter > 65mm [HR: 6.4 (2.3–17.7)]. Conclusion: AAA diameter is a relevant risk factor for late complications. However, research is needed to clarify is these are attributable to the challenging associated anatomy or to the space free of thrombus within the sac. Judicious technique choice along with tailored follow-up strategies are advised in this subgroup of patients.Introdução: O EVAR corresponde atualmente ao principal método para correção de aneurismas da aorta abdominal. Contudo, a consciência acerca dos limites desta técnica revela-se essencial, para minimizar a ocorrência de complicações futuras. As características anatómicas do aneurisma constituem-se como os principais fatores de risco conhecidos para as complicações após EVAR. O diâmetro do saco aneurismático tem sido descrito como um fator de risco relevante para complicações futuras. Os autores têm como objetivo rever a literatura disponível que analisa a associação entre o diâmetro aneurismático e o surgimento de complicações após EVAR. Métodos: Bases de dados MEDLINE foram pesquisadas no sentido de identificar publicações que contemplassem informação específica sobre a relação do diâmetro do saco aneurismático e o surgimento de complicações após EVAR. Foram apenas considerados artigos em língua Inglesa entre os anos 2003 e 2019. O endpoint primário foi a ausência de eventos relacionados com o aneurisma. Resultados: Cinco estudos foram incluídos no artigo, reportando resultados de 8443 doentes. Em dois dos estudos incluídos, é reportado um risco aumentado de complicações relacionadas com o aneurisma (HR 1.02 per mm de aumento do saco CI95% 1.01–1.04 e HR 1.8 95% CI, 1.20–2.72; P = .005). Dois estudos reportam um risco mais alto de rotura pós-implante e de conversão para cirurgia aberta em aneurismas com diâmetros superiores a 60mm. Por fim, um estudo reporta maior risco de complicações relacionadas com o colo em aneurismas com diâmetro > 65mm. [HR: 6.4 (2.3–17.7)]. Conclusão: O diâmetro do saco aneurismático representa um fator de risco relevante para complicações futuras. Contudo, não esta esclarecido se esta relação se deve a uma anatomia mais hostil em aneurismas maiores ou ao espaço livre de trombo dentro do saco. Uma correta e individualizada escolha da técnica assim como um seguimento imagiológico ajustado à anatomia pré-operatória é aconselhada neste subgrupo de doentes.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.234oai:ojs.acvjournal.com:article/234Angiologia e Cirurgia Vascular; Vol. 16 No. 1 (2020): March; 29-33Angiologia e Cirurgia Vascular; Vol. 16 N.º 1 (2020): Março; 29-332183-00961646-706Xreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPenghttp://acvjournal.com/index.php/acv/article/view/234https://doi.org/10.48750/acv.234http://acvjournal.com/index.php/acv/article/view/234/171Copyright (c) 2020 Angiologia e Cirurgia Vascularinfo:eu-repo/semantics/openAccessOliveira-Pinto, JoséSoares-Ferreira, RitaOliveira, NelsonSousa, JoelBastos-Gonçalves, FredericoLeite-Moreira, AdelinoMansilha, Armando2022-05-23T15:10:06Zoai:ojs.acvjournal.com:article/234Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T14:57:36.773312Repositório 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 IMPORTANCE OF AAA SIZE AS A PREDICTOR OF COMPLICATIONS AFTER EVAR
DIMENSÃO DO SACO ANEURISMÁTICO COMO PREDITOR DE COMPLICAÇÕES APÓS O EVAR
title IMPORTANCE OF AAA SIZE AS A PREDICTOR OF COMPLICATIONS AFTER EVAR
spellingShingle IMPORTANCE OF AAA SIZE AS A PREDICTOR OF COMPLICATIONS AFTER EVAR
Oliveira-Pinto, José
Endovascular Aneurysm repair
Aneurysm sac
Diameter
Outcome
Correção endovascular de aneurisma da aorta abdominal
Saco aneurismático
Diâmetro
Resultado
title_short IMPORTANCE OF AAA SIZE AS A PREDICTOR OF COMPLICATIONS AFTER EVAR
title_full IMPORTANCE OF AAA SIZE AS A PREDICTOR OF COMPLICATIONS AFTER EVAR
title_fullStr IMPORTANCE OF AAA SIZE AS A PREDICTOR OF COMPLICATIONS AFTER EVAR
title_full_unstemmed IMPORTANCE OF AAA SIZE AS A PREDICTOR OF COMPLICATIONS AFTER EVAR
title_sort IMPORTANCE OF AAA SIZE AS A PREDICTOR OF COMPLICATIONS AFTER EVAR
author Oliveira-Pinto, José
author_facet Oliveira-Pinto, José
Soares-Ferreira, Rita
Oliveira, Nelson
Sousa, Joel
Bastos-Gonçalves, Frederico
Leite-Moreira, Adelino
Mansilha, Armando
author_role author
author2 Soares-Ferreira, Rita
Oliveira, Nelson
Sousa, Joel
Bastos-Gonçalves, Frederico
Leite-Moreira, Adelino
Mansilha, Armando
author2_role author
author
author
author
author
author
dc.contributor.author.fl_str_mv Oliveira-Pinto, José
Soares-Ferreira, Rita
Oliveira, Nelson
Sousa, Joel
Bastos-Gonçalves, Frederico
Leite-Moreira, Adelino
Mansilha, Armando
dc.subject.por.fl_str_mv Endovascular Aneurysm repair
Aneurysm sac
Diameter
Outcome
Correção endovascular de aneurisma da aorta abdominal
Saco aneurismático
Diâmetro
Resultado
topic Endovascular Aneurysm repair
Aneurysm sac
Diameter
Outcome
Correção endovascular de aneurisma da aorta abdominal
Saco aneurismático
Diâmetro
Resultado
description Introduction: EVAR represents the preferred modality for Abdominal Aortic Aneurysms (AAA) repair. However, a comprehension regarding its limits is paramount to avoid future complications. AAA sac diameter has been described as a relevant risk factor for late complications. The purpose of this study is to summarize relevant findings regarding the association between AAA diameter and AAA-related complications. Methods: MEDLINE databases were searched to identify data addressing specific information on the relation between AAA sac diameter and incidence of AAA-related complications. Only articles in English language between 2003 and 2019 was included. Primary endpoint was freedom from aneurysm-related complications. Results: Five studies were included in our report, including 8443 patients. In two of the included studies patients with larger AAA sacs were at increased risk for aneurysm-related complications after EVAR (HR 1.02 per mm increase CI95% 1.01–1.04 and HR 1.8 95% CI, 1.20–2.72; P = .005). Two studies reported a higher risk of post implant ruptures (HR: 7.7 CI95% 3.1–18.7;) and late conversions (HR 1.6 CI 95% 1.1–2.3) in patients with AAA diameters over 6 and 6.5 cm, respectively. Finally, one study reported a higher rate of neck-related events in patients with AAA diameter > 65mm [HR: 6.4 (2.3–17.7)]. Conclusion: AAA diameter is a relevant risk factor for late complications. However, research is needed to clarify is these are attributable to the challenging associated anatomy or to the space free of thrombus within the sac. Judicious technique choice along with tailored follow-up strategies are advised in this subgroup of patients.
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
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status_str publishedVersion
dc.identifier.uri.fl_str_mv https://doi.org/10.48750/acv.234
oai:ojs.acvjournal.com:article/234
url https://doi.org/10.48750/acv.234
identifier_str_mv oai:ojs.acvjournal.com:article/234
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv http://acvjournal.com/index.php/acv/article/view/234
https://doi.org/10.48750/acv.234
http://acvjournal.com/index.php/acv/article/view/234/171
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
dc.format.none.fl_str_mv 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; 29-33
Angiologia e Cirurgia Vascular; Vol. 16 N.º 1 (2020): Março; 29-33
2183-0096
1646-706X
reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
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instacron:RCAAP
instname_str Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron_str RCAAP
institution RCAAP
reponame_str Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
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repository.name.fl_str_mv Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
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