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DOI :10.18017/iuitfd.381017   IUP :10.18017/iuitfd.381017    Full Text (PDF)

VASCULAR COMPLICATIONS OF ENDOVASCULAR AORTIC ANEURISM REPAIR: SHORT AND LONG TERM FOLLOW-UP

İsmail Cem Sormaz, Şevki Murat Aksoy

Objective: An intervention is recommended in patients, who present with an infrarenal abdominal aortic aneurysm (AAA) of more than 5.5 cm in diameter. Endovascular repair, which has been carried out more than 20 years provides reduced perioperative mortality rates and shorter intensive care and hospital stay, and less bleeding. However, it is not without complications in the short and long term. Vascular complications constitute a major part of them and may contribute to the mortality and mobidity rates. This study aims to evaluate the incidence of vascular complications of Endovascular Aortic Aneurysm Repair (EVAR) in short and long term.
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Materials and Methods: This study included 79 consecutive patients, who have undergone endovascular repair for an infrarenal abdominal aortic aneurysm, between June 2000- Jan 2010. The archive files and follow-up data of the patients were analyzed. Demography of patients, aneurysm spesifications, mortality and morbidity rate in short and long term and vascular complications were analyzed. 

Results: The mean age of the patients were 67.4±2.49 (33-86). The majority of the patients was male (85%). Perioperative mortality was 1.2%. Rupture occurred in a patient (1.2%) during the follow-up. Type I, type II and type V endoleak were present in 5%, 7.2% and 3.7%, respectively. Sac enlargement occured in 8.8% of the patients, whilst 65% of the aneurysm shrinked and 27% stayed stable in diameter. Limb thrombosis occured in 9 (11%) patients, migration in 3 (3.6%) patients and pseudoaneurysm in 1 (1.2%) patient. A conversion to open surgery was carried out for a Type Ia endoleak. The mean follow-up was 26.7 mo (6 mo-10 years). The probability of survival was 91.2%, 82.1% and 70.7% at 1st, 2nd and 4th years respectively. 

Conclusion: Perioperative mortality and morbidity rates are low following endovascular repair for an AAA. However, it should be noted that follow-up can be troublesome anytime with vascular complications, which may necessitate an interventiom. Therefore, a life-long meticulous follow-up is essential. Although the incidence of vascular complications may be high, not every vascular complication needs to be repaired. Furthermore, many of the complications can be managed by endovascular means with lower rates of mortality and morbidity.
Keywords: Endovascular aortic aneurism repair, abdominal aortic aneurysm, vascular complication
DOI :10.18017/iuitfd.381017   IUP :10.18017/iuitfd.381017    Full Text (PDF)

ENDOVASKÜLER AORT ANEVRİZMA TAMİRİ: ERKEN VE GEÇ DÖNEM VASKÜLER KOMPLİKASYONLARI

İsmail Cem Sormaz, Şevki Murat Aksoy

Amaç: İnfrarenal abdominal aort anevrizmasının (AAA) 5,5 cm çapın üzerine çıktığı olgularda rüptürün önlenmesi amacı ile bir girişim yapılması önerilmektedir. Yirmi yıldan uzun süredir uygulanan endovasküler stent ile aort anevrizması tamiri, daha kısa yoğun bakımda kalış süresi, daha az kanama ve daha kısa ameliyat ve hastanede yatış süresi gibi avantajlarla ön plana çıkmaktadır. Ancak bu metotda da erken ve geç dönem komplikasyonlar gelişmektedir. Bunlar arasında da vasküler komplikasyonlar morbiditeyi ve mortaliteyi arttırtan bir tabloyu oluşturmaktadır. Bu çalışmada Endovasküler Aort Anevrizma Tamiri (EVAR) uygulanan olguların erken ve geç dönem vasküler komplikasyonları değerlendirilecektir. 

Gereç ve Yöntem: Bu çalışmaya Haziran 2000-Ocak 2010 tarihleri arasında infrarenal AAA nedeni ile endovasküler aort onarımı uygulanan ardışık 79 olgu dahil edildi.  Olguların arşivden dosyaları çıkartıldı ve poliklinik takipleri retrospektif olarak incelendi. Demografik veriler ve anevrizmanın özellikleri erken dönem ve geç mortalite ve morbidite ve vasküler komplikasyonlar oranları incelendi. 

Bulgular: Olguların ortalama yaşı 67,4±2,49 (33-86) idi. Olguların büyük bölümü erkekti (%85). Perioperatif mortalite %1,2 olarak saptandı. Rüptür bir olguda görüldü (%1,2). Tip I, tip II ve tip V endoleakler sırasıyla %5, %7,2 ve  %3,7 olarak saptandı. Anevrizma çapı %8,8 olguda artış gösterdi, %65 olguda küçüldü ve %27 olguda stabil kaldı. Dokuz olguda (%11) greft bacak trombozu, 3 (%3,6) olguda migrasyon ve 1 (%1,2) olguda yalancı anevrizma gelişti. Tip Ia endokaçağı olan bir hastaya cerrahi konversiyon uygulandı. Ortalama takip süresi 26,7 ay (6 ay-10 yıl) olarak saptandı. On ikinci ay, 24. ay ve 48. aylarda genel sağkalım beklentisi sırasıyla %91,2, %82,1 ve %70,7 olarak tespit edildi. 

Sonuç: AAA’nın endovasküler stent greft ile onarımı sonrası perioperatif mortalite ve morbidite düşüktür fakat uzun dönem takiplerde ek girişim gerektirecek komplikasyonların çıkabileceği akıldan çıkarılmamalı ve hastalar aynı titizlikle ömür boyu takip edilmelidir. Komplikasyon oranları yüksek olmasına rağmen her komplikasyona girişim yapılmasına gerek yoktur ve komplikasyonlar endovasküler yolla çözülebileceği için mortalite ve morbiditesi de düşüktür. 
Keywords: Endovasküler aort anevrizma tamiri, abdominal aort anevrizması, vasküler komplikasyon

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APA

Sormaz, İ., & Aksoy, Ş. (2018). VASCULAR COMPLICATIONS OF ENDOVASCULAR AORTIC ANEURISM REPAIR: SHORT AND LONG TERM FOLLOW-UP. Journal of Istanbul Faculty of Medicine, 81(1), 1-10. https://doi.org/10.18017/iuitfd.381017


AMA

Sormaz İ, Aksoy Ş. VASCULAR COMPLICATIONS OF ENDOVASCULAR AORTIC ANEURISM REPAIR: SHORT AND LONG TERM FOLLOW-UP. Journal of Istanbul Faculty of Medicine. 2018;81(1):1-10. https://doi.org/10.18017/iuitfd.381017


ABNT

Sormaz, İ.; Aksoy, Ş. VASCULAR COMPLICATIONS OF ENDOVASCULAR AORTIC ANEURISM REPAIR: SHORT AND LONG TERM FOLLOW-UP. Journal of Istanbul Faculty of Medicine, [Publisher Location], v. 81, n. 1, p. 1-10, 2018.


Chicago: Author-Date Style

Sormaz, İsmail Cem, and Şevki Murat Aksoy. 2018. “VASCULAR COMPLICATIONS OF ENDOVASCULAR AORTIC ANEURISM REPAIR: SHORT AND LONG TERM FOLLOW-UP.” Journal of Istanbul Faculty of Medicine 81, no. 1: 1-10. https://doi.org/10.18017/iuitfd.381017


Chicago: Humanities Style

Sormaz, İsmail Cem, and Şevki Murat Aksoy. “VASCULAR COMPLICATIONS OF ENDOVASCULAR AORTIC ANEURISM REPAIR: SHORT AND LONG TERM FOLLOW-UP.” Journal of Istanbul Faculty of Medicine 81, no. 1 (May. 2025): 1-10. https://doi.org/10.18017/iuitfd.381017


Harvard: Australian Style

Sormaz, İ & Aksoy, Ş 2018, 'VASCULAR COMPLICATIONS OF ENDOVASCULAR AORTIC ANEURISM REPAIR: SHORT AND LONG TERM FOLLOW-UP', Journal of Istanbul Faculty of Medicine, vol. 81, no. 1, pp. 1-10, viewed 15 May. 2025, https://doi.org/10.18017/iuitfd.381017


Harvard: Author-Date Style

Sormaz, İ. and Aksoy, Ş. (2018) ‘VASCULAR COMPLICATIONS OF ENDOVASCULAR AORTIC ANEURISM REPAIR: SHORT AND LONG TERM FOLLOW-UP’, Journal of Istanbul Faculty of Medicine, 81(1), pp. 1-10. https://doi.org/10.18017/iuitfd.381017 (15 May. 2025).


MLA

Sormaz, İsmail Cem, and Şevki Murat Aksoy. “VASCULAR COMPLICATIONS OF ENDOVASCULAR AORTIC ANEURISM REPAIR: SHORT AND LONG TERM FOLLOW-UP.” Journal of Istanbul Faculty of Medicine, vol. 81, no. 1, 2018, pp. 1-10. [Database Container], https://doi.org/10.18017/iuitfd.381017


Vancouver

Sormaz İ, Aksoy Ş. VASCULAR COMPLICATIONS OF ENDOVASCULAR AORTIC ANEURISM REPAIR: SHORT AND LONG TERM FOLLOW-UP. Journal of Istanbul Faculty of Medicine [Internet]. 15 May. 2025 [cited 15 May. 2025];81(1):1-10. Available from: https://doi.org/10.18017/iuitfd.381017 doi: 10.18017/iuitfd.381017


ISNAD

Sormaz, İsmail Cem - Aksoy, Şevki Murat. “VASCULAR COMPLICATIONS OF ENDOVASCULAR AORTIC ANEURISM REPAIR: SHORT AND LONG TERM FOLLOW-UP”. Journal of Istanbul Faculty of Medicine 81/1 (May. 2025): 1-10. https://doi.org/10.18017/iuitfd.381017



TIMELINE


Submitted19.01.2018
Accepted01.02.2018
Published Online15.03.2018

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