Correção de aneurisma por via endovascular: fatores de risco para oclusão de ramo

Background

Limb occlusion is an important complication of endovascular aneurysm repair (EVAR). We intend to conduct a systematic review of the literature to assess the occurrence and the average time of limb occlusion and identify associated risk factors.

Material and methods

A literature search was performed using the query EVAR LIMB OCCLUSION, limited in time to the last ten years, to articles written in Portuguese and English. We selected twenty articles with original data; fourteen from the literature and six from the reference lists of articles read during the selection process.

Results

The frequency of limb occlusion varies between 0% and 24%. In most studies, the elapsed time to limb occlusion rarely exceeds six months. Age, body mass index, tortuosity of the iliac vessels, stenosis of the iliac or femoral artery> 70%, graft type and configuration, limb kinking, anchoring in the external iliac artery (EIA), tertiary hospital, absence of primary stenting during the index procedure and failure to comply to the specific instructions for use were identified as risk factors for limb occlusion.

Conclusions

Demographic/co‐morbidities factors seem to have a minor impact in outcome limb occlusion compared to risk factors related to arterial anatomy and related to the surgical technique. The type of graft, the anchoring zone in the EIA and the tortuosity of the iliac vessels seem to be the most important risk factors.