Tratamento endovascular versus tratamento aberto de aneurisma de artéria poplítea: artigo de revisão

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O tratamento convencional do aneurisma da artéria poplítea é a cirurgia aberta de exclusão do aneurisma e revascularização do membro acometido. Nos últimos anos, o tratamento endovascular vem ganhando popularidade e interesse. O tratamento endovascular é menos invasivo e de menor morbidade; porém, é de alto custo e sua perviedade é incerta. O objetivo desta revisão é comparar os dois tratamentos através da análise de desfechos abordados em estudos primários e secundários. Realizou-se uma revisão narrativa da literatura publicada nos últimos 5 anos. Foram selecionados seis estudos retrospectivos, duas metanálises, um ensaio clínico e uma revisão sistemática Cochrane. Número limitado de pacientes e curto período de seguimento não nos permitem extrair conclusões consistentes. Não há evidência clara que sugere melhores resultados entre um ou outro tratamento eletivo. Novos ensaios randomizados devem ser realizados para determinar o papel do tratamento endovascular desse aneurisma.

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Most cited references 35

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Open repair versus endovascular treatment for asymptomatic popliteal artery aneurysm: results of a prospective randomized study.

P Frigatti, Rudi Stramanà, Rodolfo M. Antonello … (2005)

The aim of this prospective randomized study was to evaluate the relative risks and advantages of using the Hemobahn graft for popliteal artery aneurysm (PAA) treatment compared with open repair (OR). The primary end point was patency rate; secondary end points were hospital stay and length of surgical procedure. The study was a prospective, randomized clinical trial carried out at a single center from January 1999 to December 2003. Inclusion criteria were an aneurysmal lesion in the popliteal artery with a diameter > or = 2 cm at the angio-computed tomography (CT) scan, and proximal and distal neck of the aneurysm with a length of > 1 cm to offer a secure site of fixation of the stent graft. Exclusion criteria were age 120 degrees) at 6 and 12 months, and then yearly. Between January 1999 and December 2003, 30 PAAs were performed: 15 OR (group A) and 15 ET (group B). Bypass and exclusion of the PAA was the preferred method of OR; no perioperative graft failure was observed. Twenty stent grafts were placed in 15 PAAs. Endograft thrombosis occurred in one patient (6.7%) in the postoperative period. The mean follow-up period was 46.1 months (range, 12 to 72 months) for group A and 45.9 months (range, 12 to 65 months) for group B. Kaplan-Meier analysis showed a primary patency rate of 100% at 12 months for OR and 86.7% at 12 months with a secondary patency rate of 100% at 12 and 36 months for ET. No statistical differences were observed at the log-rank test. The mean operation time (OR, 155.3 minutes; ET, 75.4 minutes) and hospital stay (OR, 7.7 days; ET, 4.3 days) were statistically longer for OR compared with ET (P < .01). We can conclude, with the power limitation of the study, that PAA treatment can be safely performed by using either OR or ET. ET has several advantages, such as quicker recovery and shorter hospital stay.

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Surgical technique and long-term results after popliteal artery aneurysm repair: results from 717 legs.

Hans Peter Ravn, Anders Wanhainen, Martin Bjorck (2007)

This study investigated the importance of surgical technique on long-term outcome after treatment of popliteal artery aneurysms (PAAs).

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A multicentric experience with open surgical repair and endovascular exclusion of popliteal artery aneurysms.

R Pulli, J. Dorigo-Zetsma, A. P. Castelli … (2013)

The aim of this study was to analyse early and follow-up results of the treatment of popliteal artery aneurysms (PAAs) performed with open surgical repair or with endovascular exclusion with endografts in a multicentric retrospective registry involving seven Italian vascular centres.

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Author and article information

Journal

Journal ID (nlm-ta): J Vasc Bras

Journal ID (iso-abbrev): J Vasc Bras

Journal ID (publisher-id): jvb

Title: Jornal Vascular Brasileiro

Publisher: Sociedade Brasileira de Angiologia e de Cirurgia Vascular (SBACV)

ISSN (Print): 1677-5449

ISSN (Electronic): 1677-7301

Publication date (Print and electronic): Jan-Mar 2018

Publication date (Print): Jan-Mar 2018

Volume: 17

Issue: 1

Pages: 34-41

Affiliations

[1 ] original Universidade Federal da Paraíba – UFPB, Departamento de Cirurgia, João Pessoa, PB, Brasil.

[2 ] original Universidade Federal de São Paulo – UNIFESP, Departamento de Cirurgia Vascular e Endovascular, São Paulo, SP, Brasil.

[3 ] original Universidade Federal de Juiz de Fora – UFJF, Departamento de Cirurgia, Juiz de Fora, MG, Brasil.

[4 ] original Faculdade de Medicina Nova Esperança – FAMENE, Departamento de Cirurgia, João Pessoa, PB, Brasil.

[1 ] original Universidade Federal da Paraíba – UFPB, Departamento de Cirurgia, João Pessoa, PB, Brasil.

[2 ] original Universidade Federal de São Paulo – UNIFESP, Departamento de Cirurgia Vascular e Endovascular, São Paulo, SP, Brasil.

[3 ] original Universidade Federal de Juiz de Fora – UFJF, Departamento de Cirurgia, Juiz de Fora, MG, Brasil.

[4 ] original Faculdade de Medicina Nova Esperança – FAMENE, Departamento de Cirurgia, João Pessoa, PB, Brasil.

Author notes

Conflito de interesse: Os autores declararam não haver conflitos de interesse que precisam ser informados.

[* ] Correspondência Daniel Guimarães Cacione Rua Borges Lagoa, 754 - Vila Clementino CEP 04038-001 - São Paulo (SP), Brasil Tel.: (11) 99968-5132 E-mail: dancac@ 123456gmail.com

Informações sobre os autores RNB - aluno do 6º ano do curso de medicina, Universidade Federal da Paraíba (UFPB). DGC - doutor em saúde baseada em evidências pela Universidade Federal de São Paulo (UNIFESP). FCVB - doutor em biotecnologia na área de saúde pela Renorbio, Universidade Federal de Alagoas (UFAL). ASP - aluna do 6º ano do curso de medicina, Universidade Federal de Juiz de Fora (UFJF). CONL - aluna do 6º ano do curso de medicina, Faculdade de Medicina Nova Esperança (FAMENE). LCUN - doutor em medicina (cirurgia cardiovascular) pela Universidade Federal de São Paulo (UNIFESP).

Contribuições dos autores Concepção e desenho do estudo: LCUN, DGC Análise e interpretação dos dados: RNB Coleta de dados: RNB Redação do artigo: RNB Revisão crítica do texto: LCUN, DGC, ASP, CONL Aprovação final do artigo*: RNB, DGC, FCVB, ASP, CONL, LCUN Análise estatística: RNB Responsabilidade geral pelo estudo: RNB *Todos os autores leram e aprovaram a versão final submetida ao J Vasc Bras.

Conflicts of interest: No conflicts of interest declared concerning the publication of this article.

[* ] Correspondence Daniel Guimarães Cacione Rua Borges Lagoa, 754 - Vila Clementino CEP 04038-001 - São Paulo (SP), Brasil Tel.: +55 (11) 99968-5132 E-mail: dancac@ 123456gmail.com

Author information RNB - Medical student (6th year), Universidade Federal da Paraíba (UFPB). DGC - PhD in Evidence-Based Health, Universidade Federal de São Paulo (UNIFESP). FCVB - PhD in Biotechnology in Health, Renorbio, Universidade Federal de Alagoas (UFAL). ASP - Medical student (6th year), Universidade Federal de Juiz de Fora (UFJF). CONL - Medical student (6th year), Faculdade de Medicina Nova Esperança (FAMENE). LCUN - PhD in Medicine (cardiovascular surgery), Universidade Federal de São Paulo (UNIFESP).

Author contributions Conception and design: LCUN, DGC Analysis and interpretation: RNB Data collection: RNB Writing the article: RNB Critical revision of the article: LCUN, DGC, ASP, CONL Final approval of the article*: RNB, DGC, FCVB, ASP, CONL, LCUN Statistical analysis: RNB Overall responsibility: RNB * All authors have read and approved of the final version of the article submitted to J Vasc Bras.

Article

Publisher ID: jvbAR20170049_PT

DOI: 10.1590/1677-5449.004917

PMC ID: 5990263

SO-VID: 39e44593-c602-48be-b4f7-70a5e6702267

License:

Este é um artigo publicado em acesso aberto (Open Access) sob a licença Creative Commons Attribution, que permite uso, distribuição e reprodução em qualquer meio, sem restrições desde que o trabalho original seja corretamente citado.

History

Date received : 19 September 2017

Date accepted : 27 December 2017

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Figures: 0, Tables: 4, Equations: 0, References: 34, Pages: 8

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Tratamento endovascular versus tratamento aberto de aneurisma de artéria poplítea: artigo de revisão

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Most cited references 35

Open repair versus endovascular treatment for asymptomatic popliteal artery aneurysm: results of a prospective randomized study.

Surgical technique and long-term results after popliteal artery aneurysm repair: results from 717 legs.

A multicentric experience with open surgical repair and endovascular exclusion of popliteal artery aneurysms.

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