RESUMO
INTRODUCTION AND OBJECTIVES: The aim of this study is to report our experience on the postoperative outcome of surgical treatment of inflammatory abdominal aortic aneurysm (IAAA). MATERIALS AND METHODS: Between January 1997 and March 2014, 35 patients with IAAA underwent surgery. The mean age was 63 ± 18 years. Chronic renal failure was identified in 11 (31.4%) patients, and ischemic heart disease was confirmed in 15 (43%) patients. The mean aortic aneurysm diameter was 68 ± 25 mm. The abdominal aorta was clamped above the renal arteries in 6 (17%) patients. RESULTS: The hospital mortality was 5.7% (2 patients). Three patients developed an aortic pseudoaneurysm and underwent reoperation. Another patient developed a femoral anastomotic pseudoaneurysm 7 years after operation, which was treated surgically. The overall reoperation-free actuarial survival at 1, 5, and 7 years was 94, 62, and 50%, respectively. The Cox model revealed the delta erythrocyte sedimentation rate (p = 0.002), ischemic heart disease (p = 0.006), and renal failure (p = 0.036) as strong predictors for poor overall outcome. CONCLUSION: Early postoperative outcome in terms of mortality and morbidity seems acceptable; however, patients with IAAA have an increased risk for reoperation due to pseudoaneurysm formation. Strong predictors for poor overall outcome seem to be elevated erythrocyte sedimentation rate, ischemic heart disease, and chronic renal failure.
Assuntos
Aneurisma da Aorta Abdominal/cirurgia , Aortite/cirurgia , Implante de Prótese Vascular , Adulto , Idoso , Aneurisma da Aorta Abdominal/diagnóstico , Aneurisma da Aorta Abdominal/mortalidade , Aortite/diagnóstico , Aortite/mortalidade , Implante de Prótese Vascular/efeitos adversos , Implante de Prótese Vascular/mortalidade , Feminino , Mortalidade Hospitalar , Humanos , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Complicações Pós-Operatórias/mortalidade , Complicações Pós-Operatórias/cirurgia , Valor Preditivo dos Testes , Modelos de Riscos Proporcionais , Reoperação , Fatores de Risco , Fatores de Tempo , Resultado do TratamentoRESUMO
OBJECTIVES: The aim of this study is to report our experience on the postoperative outcome of surgical treatment of inflammatory abdominal aortic aneurysm (IAAA). MATERIALS AND METHODS: Between 1997-2014, 35 patients with IAAA underwent surgery. The mean age was 63 ± 18 years. Chronic renal failure was identified in 11 (31.4%) patients and confirmed ischemic heart disease in 15 (43%) patients. The mean aortic aneurysm diameter was 68 ± 25 mm. The abdominal aorta was clamped above the renal arteries in 6 (17%) patients. RESULTS: The hospital mortality was 5.7% (2 patients). Three patients developed an aortic pseudoaneurysm and underwent a redo operation. Another patient developed a femoral anastomotic pseudoaneurysm 7 years after operation and he was treated surgically. The actuarial free-reoperation actuarial survival at 1, 5 and 7 years was 94%, 62% and 50%, respectively. The Cox model revealed the delta erythrocyte sedimentation rate (p = 0.002), ischemic heart disease (p = 0.006) and renal failure (p = 0.036) as strong predictors for poor overall outcome. CONCLUSION: Early postoperative outcome in terms of mortality and morbidity seems acceptable, however, patients with IAAA have an increased risk for reoperation due to pseudonaneurysm formation. Strong predictors for poor overall outcome seem to be the elevated erythrocyte sedimentation rate, ischemic heart disease and chronic renal failure.
RESUMO
OBJECTIVES: The aim of this study is to report our experience on the postoperative outcome of surgical treatment of inflammatory abdominal aortic aneurysm (IAAA). MATERIALS AND METHODS: Between 1997-2014, 35 patients with IAAA underwent surgery. The mean age was 63+/-18years. Chronic renal failure was identified in 11(31.4%)patients and confirmed ischemic heart disease in 15(43%)patients. The mean aortic aneurysm diameter was 68+/-25mm. The abdominal aorta was clamped above the renal arteries in 6 (17%) patients. RESULTS: The hospital mortality was 5.7% (2 patients). Three patients developed an aortic pseudoaneurysm and underwent a redo operation. Another patient developed a femoral anastomotic pseudoaneurysm 7 years after operation and he was treated surgically. The actuarial free-reoperation actuarial survival at 1, 5 and 7 years was 94%, 62% and 50% respectively. The Cox model revealed the delta ESR (p=0.002), ischemic heart disease (p=0.006) and renal failure (p=0.036) as strong predictors for poor overall outcome. CONCLUSION: Early postoperative outcome in terms of mortality and morbidity seems acceptable, however patients with IAAA have an increased risk for reoperation due to pseudonaneurysm formation. Strong predictors for poor overall outcome seems to be the elevated erythrocyte sedimentation rate, ischemic heart disease and chronic renal failure.
