Antonio Carlos Brandi, Carlos Alberto Dos Santos, Josélia Menin Brandi, Marcio Antonio Dos Santos, Paulo Henrique Husseine Botelho
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Intraoperative, postoperative, and late postoperative outcomes were evaluated in terms of complications, mortality, and evolution of the endoprosthesis over a follow-up of up to 179 months (median: 46 months).</p><p><strong>Results: </strong>A total of 150 endoprostheses were implanted in 112 patients. Primary success was observed in 100 (82.14%) patients. Immediate mortality occurred in 7 patients (6.25%). Late mortality occurred in 31 patients (27.68%), 10 (8.93%) of whom died from cardiovascular causes, 12 (10.71%) from non-cardiovascular causes, and 2 (1.78%) from natural causes, while 7 (6.25%) had no diagnosis for cause of death. Types I, II, and IV endoleaks occurred during hospitalization in 4 (3.57%), 5 (4.46%), and 3 (2.68%) patients, respectively. Late types I and IV endoleaks occurred in 5 (4.46%) and 3 (2.68%) patients respectively. Twenty-two patients (19.64%) had clinical complications in the immediate postoperative period. Actuarial survival free from death from cardiovascular causes was 79.3% (95% confidence interval, 67.0-91.7%) at 132 months.</p><p><strong>Conclusions: </strong>The low levels of intraoperative and postoperative complications demonstrate that endovascular treatment is safe and effective. The high rate of late survival for these critically ill patients indicates that the endovascular technique is beneficial for treatment of thoracic aortic diseases in terms of long-term outcomes.</p>","PeriodicalId":14814,"journal":{"name":"Jornal Vascular Brasileiro","volume":"22 ","pages":"e20220156"},"PeriodicalIF":0.8000,"publicationDate":"2023-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10706006/pdf/","citationCount":"0","resultStr":"{\"title\":\"Long-term outcomes after endovascular aortic treatment in patients with thoracic aortic diseases.\",\"authors\":\"Antonio Carlos Brandi, Carlos Alberto Dos Santos, Josélia Menin Brandi, Marcio Antonio Dos Santos, Paulo Henrique Husseine Botelho\",\"doi\":\"10.1590/1677-5449.202201562\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Endovascular treatments for thoracic aortic diseases have been adopted rapidly, and long-term studies are relevant for durability evaluation.</p><p><strong>Objective: </strong>To evaluate the long-term results of a prospective observational study of endovascular treatment in patients with thoracic aortic diseases who underwent percutaneous implantation of self-expandable endoprostheses.</p><p><strong>Methods: </strong>Procedural success was defined as the absence of endoleak into the aneurysm or dissection-induced false lumen, no migration, and no conversion to open surgery. Intraoperative, postoperative, and late postoperative outcomes were evaluated in terms of complications, mortality, and evolution of the endoprosthesis over a follow-up of up to 179 months (median: 46 months).</p><p><strong>Results: </strong>A total of 150 endoprostheses were implanted in 112 patients. Primary success was observed in 100 (82.14%) patients. Immediate mortality occurred in 7 patients (6.25%). Late mortality occurred in 31 patients (27.68%), 10 (8.93%) of whom died from cardiovascular causes, 12 (10.71%) from non-cardiovascular causes, and 2 (1.78%) from natural causes, while 7 (6.25%) had no diagnosis for cause of death. Types I, II, and IV endoleaks occurred during hospitalization in 4 (3.57%), 5 (4.46%), and 3 (2.68%) patients, respectively. Late types I and IV endoleaks occurred in 5 (4.46%) and 3 (2.68%) patients respectively. Twenty-two patients (19.64%) had clinical complications in the immediate postoperative period. Actuarial survival free from death from cardiovascular causes was 79.3% (95% confidence interval, 67.0-91.7%) at 132 months.</p><p><strong>Conclusions: </strong>The low levels of intraoperative and postoperative complications demonstrate that endovascular treatment is safe and effective. The high rate of late survival for these critically ill patients indicates that the endovascular technique is beneficial for treatment of thoracic aortic diseases in terms of long-term outcomes.</p>\",\"PeriodicalId\":14814,\"journal\":{\"name\":\"Jornal Vascular Brasileiro\",\"volume\":\"22 \",\"pages\":\"e20220156\"},\"PeriodicalIF\":0.8000,\"publicationDate\":\"2023-11-20\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10706006/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Jornal Vascular Brasileiro\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1590/1677-5449.202201562\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2023/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q4\",\"JCRName\":\"PERIPHERAL VASCULAR DISEASE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Jornal Vascular Brasileiro","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1590/1677-5449.202201562","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/1/1 0:00:00","PubModel":"eCollection","JCR":"Q4","JCRName":"PERIPHERAL VASCULAR DISEASE","Score":null,"Total":0}
引用次数: 0
摘要
背景:胸主动脉疾病的血管内治疗已被迅速采用,长期研究与耐久性评估相关:目的:评估一项前瞻性观察研究的长期结果,研究对象为接受经皮植入可自行扩张内膜的胸主动脉疾病患者:手术成功的定义是没有内漏进入动脉瘤或夹层引起的假腔、没有移位、没有转为开放手术。在长达179个月的随访期间(中位数:46个月),对术中、术后和术后晚期的并发症、死亡率和内膜假体的演变情况进行了评估:结果:共为 112 名患者植入了 150 个假体。100名患者(82.14%)获得了初次成功。7名患者(6.25%)出现即刻死亡。31名患者(27.68%)出现晚期死亡,其中10人(8.93%)死于心血管原因,12人(10.71%)死于非心血管原因,2人(1.78%)死于自然原因,7人(6.25%)死因不明。住院期间发生 I 型、II 型和 IV 型内漏的患者分别有 4 人(3.57%)、5 人(4.46%)和 3 人(2.68%)。晚期 I 型和 IV 型内漏分别发生在 5 名(4.46%)和 3 名(2.68%)患者身上。22名患者(19.64%)在术后即刻出现临床并发症。132个月时,无心血管疾病死亡的精算存活率为79.3%(95%置信区间,67.0-91.7%):结论:术中和术后并发症的发生率很低,这表明血管内治疗是安全有效的。结论:术中和术后并发症的发生率很低,这表明血管内治疗是安全有效的,这些重症患者的晚期存活率很高,说明血管内技术在治疗胸主动脉疾病的长期疗效方面是有益的。
Long-term outcomes after endovascular aortic treatment in patients with thoracic aortic diseases.
Background: Endovascular treatments for thoracic aortic diseases have been adopted rapidly, and long-term studies are relevant for durability evaluation.
Objective: To evaluate the long-term results of a prospective observational study of endovascular treatment in patients with thoracic aortic diseases who underwent percutaneous implantation of self-expandable endoprostheses.
Methods: Procedural success was defined as the absence of endoleak into the aneurysm or dissection-induced false lumen, no migration, and no conversion to open surgery. Intraoperative, postoperative, and late postoperative outcomes were evaluated in terms of complications, mortality, and evolution of the endoprosthesis over a follow-up of up to 179 months (median: 46 months).
Results: A total of 150 endoprostheses were implanted in 112 patients. Primary success was observed in 100 (82.14%) patients. Immediate mortality occurred in 7 patients (6.25%). Late mortality occurred in 31 patients (27.68%), 10 (8.93%) of whom died from cardiovascular causes, 12 (10.71%) from non-cardiovascular causes, and 2 (1.78%) from natural causes, while 7 (6.25%) had no diagnosis for cause of death. Types I, II, and IV endoleaks occurred during hospitalization in 4 (3.57%), 5 (4.46%), and 3 (2.68%) patients, respectively. Late types I and IV endoleaks occurred in 5 (4.46%) and 3 (2.68%) patients respectively. Twenty-two patients (19.64%) had clinical complications in the immediate postoperative period. Actuarial survival free from death from cardiovascular causes was 79.3% (95% confidence interval, 67.0-91.7%) at 132 months.
Conclusions: The low levels of intraoperative and postoperative complications demonstrate that endovascular treatment is safe and effective. The high rate of late survival for these critically ill patients indicates that the endovascular technique is beneficial for treatment of thoracic aortic diseases in terms of long-term outcomes.
期刊介绍:
The Jornal Vascular Brasileiro is editated and published quaterly to select and disseminate high-quality scientific contents concerning original research, novel surgical and diagnostic techniques, and clinical observations in the field of vascular surgery, angiology, and endovascular surgery. Its abbreviated title is J. Vasc. Bras., which should be used in bibliographies, footnotes and bibliographical references and strips.