ANEURISMATIC NECK THROMBUS, TYPE OF ENDOPROSTHESIS AND DEVELOPMENT OF TYPE IA ENDOLEAK — COULD THIS ASSOCIATION BE A PROBLEM?
Autor(a) principal: | |
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Data de Publicação: | 2019 |
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.156 |
Resumo: | Introduction: The long-term results of EVAR depend on the proximal fixation of the endoprosthesis to avoid migration and development of endoleak type Ia. The aortic neck anatomy, in particular the presence of thrombus, may influence the results of EVAR. Objectives: To study the relationship between aneurysmal neck thrombus, type of endoprosthesis used and the development of endoleak Ia. Materials/Methods: We made a retrospective analysis of the database of patients with AAA treated by EVAR at our institution between December 2001-2013. We reviewed all available preoperative CT scans (total of 164) and divided patients into two groups: with significant aortic neck thrombus (> 25% of the aortic neck circumference) versus no significant thrombus. We also studied the type of endoprosthesis (supra versus infra-renal fixation) used. Then, we evaluated the follow-up and the development of type Ia endoleak. Results: Of the 164 patients, 38 had thrombus> 25% of the aortic circumference (versus 126 with thrombus <25%). 66 patients were treated with infra-renal fixation endoprothesis and 98 with supra-renal fixation endoprothesis. The mean follow-up time was 42.88 months (± 32.49). When we considered the type of endoprosthesis used we realised that 7 (7.14%) of the patients treated with supra-renal fixation endoprosthesis and 5 (7.57%) of those treated with infra-renal fixation endoprosthesis developed type Ia endoleak. Of the 38 patients with significant thrombus, 25 were treated with supra-renal fixation endoprostheses and 1 of them (4%) developed endoleak Ia; the remaining 13 were treated with infra-renal fixation endoprostheses and 2 of them (15.38%) developed endoleak Ia, however, this difference was not statistically significant (p = 0.265). Of the 126 patients with non-significant thrombus, 73 were treated with supra-renal fixation endoprostheses and 6 of them (8.22%) developed endoleak Ia; the remaining 53 were treated with infra-renal fixation stents and of these, 3 (5.66%) developed endoleak Ia. Conclusions: The presence of a significant amount of thrombus in the aneurysmal neck does not seem to influence the development of type Ia endoleak. However, in patients with significant thrombus, although we did not obtain a statistically significant difference, we observed a higher percentage of endoleak type Ia in patients treated with infra-renal fixation endoprostheses. (15.38% versus 4%). It is necessary to maintain follow-up of these patients to draw conclusions in the future. |
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ANEURISMATIC NECK THROMBUS, TYPE OF ENDOPROSTHESIS AND DEVELOPMENT OF TYPE IA ENDOLEAK — COULD THIS ASSOCIATION BE A PROBLEM?TROMBO NO COLO ANEURISMÁTICO, TIPO DE ENDOPRÓTESE E DESENVOLVIMENTO DE ENDOLEAK TIPO IA – É ESTA ASSOCIAÇÃO UM PROBLEMAendoleakaortic neckneck thrombusaortic neck anatomysupra-renal fixationinfra-renal fixationIntroduction: The long-term results of EVAR depend on the proximal fixation of the endoprosthesis to avoid migration and development of endoleak type Ia. The aortic neck anatomy, in particular the presence of thrombus, may influence the results of EVAR. Objectives: To study the relationship between aneurysmal neck thrombus, type of endoprosthesis used and the development of endoleak Ia. Materials/Methods: We made a retrospective analysis of the database of patients with AAA treated by EVAR at our institution between December 2001-2013. We reviewed all available preoperative CT scans (total of 164) and divided patients into two groups: with significant aortic neck thrombus (> 25% of the aortic neck circumference) versus no significant thrombus. We also studied the type of endoprosthesis (supra versus infra-renal fixation) used. Then, we evaluated the follow-up and the development of type Ia endoleak. Results: Of the 164 patients, 38 had thrombus> 25% of the aortic circumference (versus 126 with thrombus <25%). 66 patients were treated with infra-renal fixation endoprothesis and 98 with supra-renal fixation endoprothesis. The mean follow-up time was 42.88 months (± 32.49). When we considered the type of endoprosthesis used we realised that 7 (7.14%) of the patients treated with supra-renal fixation endoprosthesis and 5 (7.57%) of those treated with infra-renal fixation endoprosthesis developed type Ia endoleak. Of the 38 patients with significant thrombus, 25 were treated with supra-renal fixation endoprostheses and 1 of them (4%) developed endoleak Ia; the remaining 13 were treated with infra-renal fixation endoprostheses and 2 of them (15.38%) developed endoleak Ia, however, this difference was not statistically significant (p = 0.265). Of the 126 patients with non-significant thrombus, 73 were treated with supra-renal fixation endoprostheses and 6 of them (8.22%) developed endoleak Ia; the remaining 53 were treated with infra-renal fixation stents and of these, 3 (5.66%) developed endoleak Ia. Conclusions: The presence of a significant amount of thrombus in the aneurysmal neck does not seem to influence the development of type Ia endoleak. However, in patients with significant thrombus, although we did not obtain a statistically significant difference, we observed a higher percentage of endoleak type Ia in patients treated with infra-renal fixation endoprostheses. (15.38% versus 4%). It is necessary to maintain follow-up of these patients to draw conclusions in the future.Introdução: Os resultados a longo prazo do EVAR dependem da fixação proximal da endoprótese de forma a evitar migração da mesma e o desenvolvimento de endoleak tipo Ia. As características anatómicas do colo aneurismático, nomeadamente a presença de trombo, podem influenciar os resultados do EVAR. Objetivos: Estudar a relação entre o trombo do colo aneurismático e o tipo de endoprótese utilizada e o desenvolvimento de endoleak Ia. Materiais/Métodos: Análise retrospetiva da base de dados de doentes com AAA tratados por EVAR na nossa instituição entre dezembro 2001-2013. Procedemos à revisão de todos os angioTACs pré-operatórios disponíveis (total de 164) e dividimos os doentes em dois grupos: com trombo significativo no colo aneurismático (>25% da circunferência do colo) versus sem trombo significativo. Estudamos ainda o tipo de endoprótese (fixação supra versus infra-renal) utilizada. Posteriormente, avaliamos o follow-up e o desenvolvimento de endoleak tipo Ia. Resultados: Dos 164 doentes, 38 doentes apresentavam trombo > 25% da circunferência aórtica (versus 126 com trombo <25%). 66 doentes foram tratados com endopróteses de fixação infra-renal e 98 com endopróteses de fixação supra-renal. O tempo médio de follow-up foi de 42.88 meses (±32.49). 3 (7.89%) dos doentes com trombo significativo e 9 (7.14%) dos doentes sem trombo significativo desenvolveram endoleak Ia. Quando consideramos o tipo de endoprótese utilizada, verificamos que 7 (7.14%) dos doentes tratados com endopróteses de fixação supra-renal e 5 (7.57%) dos tratados com endopróteses de fixação infra-renal desenvolveram endoleak Ia. Dos 38 doentes com trombo significativo, 25 foram tratados com endopróteses de fixação supra-renal e destes, 1 (4%) desenvolveu endoleak Ia; os restantes 13 foram tratados com endopróteses de fixação infra-renal e destes 2 (15.38%) desenvolveram endoleak Ia, no entanto, esta diferença não foi estatisticamente significativa (p=0.265). Dos 126 doentes com trombo não significativo, 73 foram tratados com endopróteses de fixação supra-renal e destes, 6 (8.22%) desenvolveram endoleak Ia; os restantes 53 foram tratados com endopróteses de fixação infra-renal e destes, 3 (5.66%) desenvolveram endoleak Ia. Conclusões: A presença significativa de trombo no colo aneurismático não parece influenciar o desenvolvimento de endoleak tipo Ia. No entanto, nos doentes com trombo significativo, apesar de não termos obtido diferença estatisticamente significativa, observamos uma maior percentagem de endoleak tipo Ia nos doentes tratados com endopróteses de fixação infra-renal (15.38% versus 4%) sendo necessário manter o seguimento destes doentes de modo a podermos tirar conclusões no futuro.Sociedade Portuguesa de Angiologia e Cirurgia Vascular2019-09-04T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttps://doi.org/10.48750/acv.156oai:ojs.acvjournal.com:article/156Angiologia e Cirurgia Vascular; Vol. 15 No. 1 (2019): March; 1-6Angiologia e Cirurgia Vascular; Vol. 15 N.º 1 (2019): Março; 1-62183-00961646-706Xreponame: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/156https://doi.org/10.48750/acv.156http://acvjournal.com/index.php/acv/article/view/156/125Copyright (c) 2019 Angiologia e Cirurgia Vascularinfo:eu-repo/semantics/openAccessAntunes, InêsMachado, RuiRego, DuarteFerreira, VítorGonçalves, JoãoTeixeira, GabrielaVeiga, CarlosMendes, DanielVeterano, CarlosPereira, CarlosAlmeida, Rui2022-05-23T15:10:03Zoai:ojs.acvjournal.com:article/156Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T14:57:33.093203Repositório 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 |
ANEURISMATIC NECK THROMBUS, TYPE OF ENDOPROSTHESIS AND DEVELOPMENT OF TYPE IA ENDOLEAK — COULD THIS ASSOCIATION BE A PROBLEM? TROMBO NO COLO ANEURISMÁTICO, TIPO DE ENDOPRÓTESE E DESENVOLVIMENTO DE ENDOLEAK TIPO IA – É ESTA ASSOCIAÇÃO UM PROBLEMA |
title |
ANEURISMATIC NECK THROMBUS, TYPE OF ENDOPROSTHESIS AND DEVELOPMENT OF TYPE IA ENDOLEAK — COULD THIS ASSOCIATION BE A PROBLEM? |
spellingShingle |
ANEURISMATIC NECK THROMBUS, TYPE OF ENDOPROSTHESIS AND DEVELOPMENT OF TYPE IA ENDOLEAK — COULD THIS ASSOCIATION BE A PROBLEM? Antunes, Inês endoleak aortic neck neck thrombus aortic neck anatomy supra-renal fixation infra-renal fixation |
title_short |
ANEURISMATIC NECK THROMBUS, TYPE OF ENDOPROSTHESIS AND DEVELOPMENT OF TYPE IA ENDOLEAK — COULD THIS ASSOCIATION BE A PROBLEM? |
title_full |
ANEURISMATIC NECK THROMBUS, TYPE OF ENDOPROSTHESIS AND DEVELOPMENT OF TYPE IA ENDOLEAK — COULD THIS ASSOCIATION BE A PROBLEM? |
title_fullStr |
ANEURISMATIC NECK THROMBUS, TYPE OF ENDOPROSTHESIS AND DEVELOPMENT OF TYPE IA ENDOLEAK — COULD THIS ASSOCIATION BE A PROBLEM? |
title_full_unstemmed |
ANEURISMATIC NECK THROMBUS, TYPE OF ENDOPROSTHESIS AND DEVELOPMENT OF TYPE IA ENDOLEAK — COULD THIS ASSOCIATION BE A PROBLEM? |
title_sort |
ANEURISMATIC NECK THROMBUS, TYPE OF ENDOPROSTHESIS AND DEVELOPMENT OF TYPE IA ENDOLEAK — COULD THIS ASSOCIATION BE A PROBLEM? |
author |
Antunes, Inês |
author_facet |
Antunes, Inês Machado, Rui Rego, Duarte Ferreira, Vítor Gonçalves, João Teixeira, Gabriela Veiga, Carlos Mendes, Daniel Veterano, Carlos Pereira, Carlos Almeida, Rui |
author_role |
author |
author2 |
Machado, Rui Rego, Duarte Ferreira, Vítor Gonçalves, João Teixeira, Gabriela Veiga, Carlos Mendes, Daniel Veterano, Carlos Pereira, Carlos Almeida, Rui |
author2_role |
author author author author author author author author author author |
dc.contributor.author.fl_str_mv |
Antunes, Inês Machado, Rui Rego, Duarte Ferreira, Vítor Gonçalves, João Teixeira, Gabriela Veiga, Carlos Mendes, Daniel Veterano, Carlos Pereira, Carlos Almeida, Rui |
dc.subject.por.fl_str_mv |
endoleak aortic neck neck thrombus aortic neck anatomy supra-renal fixation infra-renal fixation |
topic |
endoleak aortic neck neck thrombus aortic neck anatomy supra-renal fixation infra-renal fixation |
description |
Introduction: The long-term results of EVAR depend on the proximal fixation of the endoprosthesis to avoid migration and development of endoleak type Ia. The aortic neck anatomy, in particular the presence of thrombus, may influence the results of EVAR. Objectives: To study the relationship between aneurysmal neck thrombus, type of endoprosthesis used and the development of endoleak Ia. Materials/Methods: We made a retrospective analysis of the database of patients with AAA treated by EVAR at our institution between December 2001-2013. We reviewed all available preoperative CT scans (total of 164) and divided patients into two groups: with significant aortic neck thrombus (> 25% of the aortic neck circumference) versus no significant thrombus. We also studied the type of endoprosthesis (supra versus infra-renal fixation) used. Then, we evaluated the follow-up and the development of type Ia endoleak. Results: Of the 164 patients, 38 had thrombus> 25% of the aortic circumference (versus 126 with thrombus <25%). 66 patients were treated with infra-renal fixation endoprothesis and 98 with supra-renal fixation endoprothesis. The mean follow-up time was 42.88 months (± 32.49). When we considered the type of endoprosthesis used we realised that 7 (7.14%) of the patients treated with supra-renal fixation endoprosthesis and 5 (7.57%) of those treated with infra-renal fixation endoprosthesis developed type Ia endoleak. Of the 38 patients with significant thrombus, 25 were treated with supra-renal fixation endoprostheses and 1 of them (4%) developed endoleak Ia; the remaining 13 were treated with infra-renal fixation endoprostheses and 2 of them (15.38%) developed endoleak Ia, however, this difference was not statistically significant (p = 0.265). Of the 126 patients with non-significant thrombus, 73 were treated with supra-renal fixation endoprostheses and 6 of them (8.22%) developed endoleak Ia; the remaining 53 were treated with infra-renal fixation stents and of these, 3 (5.66%) developed endoleak Ia. Conclusions: The presence of a significant amount of thrombus in the aneurysmal neck does not seem to influence the development of type Ia endoleak. However, in patients with significant thrombus, although we did not obtain a statistically significant difference, we observed a higher percentage of endoleak type Ia in patients treated with infra-renal fixation endoprostheses. (15.38% versus 4%). It is necessary to maintain follow-up of these patients to draw conclusions in the future. |
publishDate |
2019 |
dc.date.none.fl_str_mv |
2019-09-04T00:00:00Z |
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.156 oai:ojs.acvjournal.com:article/156 |
url |
https://doi.org/10.48750/acv.156 |
identifier_str_mv |
oai:ojs.acvjournal.com:article/156 |
dc.language.iso.fl_str_mv |
por |
language |
por |
dc.relation.none.fl_str_mv |
http://acvjournal.com/index.php/acv/article/view/156 https://doi.org/10.48750/acv.156 http://acvjournal.com/index.php/acv/article/view/156/125 |
dc.rights.driver.fl_str_mv |
Copyright (c) 2019 Angiologia e Cirurgia Vascular info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
Copyright (c) 2019 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. 15 No. 1 (2019): March; 1-6 Angiologia e Cirurgia Vascular; Vol. 15 N.º 1 (2019): Março; 1-6 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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1799129848874008576 |