Serie de casos. Experiencia de un único centro en el tratamiento de fístulas aortoentéricas / A case series. Experience of a single centre in the treatment of aortoenteric fistulas
Angiología
; 64(5): 199-205, sept.-oct. 2012. ilus, tab
Article
in Spanish
| IBECS
| ID: ibc-102626
Responsible library:
ES1.1
Localization: BNCS
RESUMEN
Objetivo:
Analizar nuestra experiencia y resultados obtenidos en una patología infrecuente, compleja y grave como la fístula aortoentérica (FAE). Material ymétodos:
La patología aórtica previa y su tratamiento fueron 4 síndromes de Leriche y 2 aneurismas de aorta y un aneurisma roto tratados con bypass aortobifemoral y dos endovascular aneurysms repair (EVAR). Otros datos recogidos fueron factores de riesgo cardiovascular, patología y cirugía abdominal previa, la localización de FAE secundaria, periodo de tiempo hasta la FAE, evolución y recidivas. Nueve pacientes (7 hombres y 2 mujeres) con fístula secundaria aortoentérica tratados durante el periodo 2000-2010 se agruparon en función de la estabilidad hemodinámica 3 hombres estables, 4 hombres y 2 mujeres inestables.Resultados:
Las FAE secundarias aparecieron tras una media de tiempo de 85,8 meses (mediana 104; rango 5-204). Cuatro se trataron con bypass extra-anatómico, 3 inestables. Tres pacientes con reparación in situ, 2 inestables. Dos de forma endovascular, uno inestable. Hubo una muerte intra-quirófano, inestable, y durante los primeros 30 días fallecieron otros 4 pacientes, 3 inestables y uno estable. Los 4 pacientes que sobrevivieron sufrieron una recidiva de la FAE tras tres meses de media (intervalo 2-5); solo dos se trataron, uno con endoprótesis y otro con bypass axilobifemoral.Conclusiones:
La FAE secundaria es una complicación grave, rara y compleja, con una alta morbilidad y mortalidad. No existe un tratamiento estándar, aunque es fundamental el tratamiento urgente de la hemorragia, incluyendo la terapia endovascular, con o sin una nueva intervención para el tratamiento definitivo(AU()ABSTRACT
Objective:
To analyse our experience and results of a rare, complex and serious disease, aortoenteric fistula (AEF). Material andmethods:
Nine patients (seven males and two females) with secondary aortoenteric fistula treated during the period 2000-2010, were grouped according to hemodynamic stability stable three males. Four males and two females were unstable. Previous aortic pathology and its treatment were four Leriche syndrome, two aortic aneurysms and a ruptured aortic aneurysm treated by aortobifemoral bypass and two EVAR (endovascular aneurysms repair). Other data collected cardiovascular risk factors, previous abdominal pathology and its surgery, the location of the secondary AEF, period of time until the appearance of AEF, evolution and recurrence.Results:
The secondary AEF appeared after a mean time of 85.8 months (median 104, range 5-204). Four were treated with extra-anatomical bypass, and three were unstable. Three patients with in situ repair, two unstable. Two with endograft, one unstable. There was one death during surgery, unstable, and during the first 30 days, four patients died, 3 unstable, one stable. The four surviving patients had a recurrence of the AEF after a mean of three months (range, 2-5), only two were treated, one patient with endograft and one with axilobifemoral bypass.Conclusions:
Secondary AEF is a serious, rare and complex complication, with high morbidity and mortality. No standard treatment exists, although the urgent treatment of bleeding is essential, including endovascular therapy, with or without a new intervention for definitive treatment(AU)
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Collection:
National databases
/
Spain
Database:
IBECS
Main subject:
Digestive System Fistula
/
Prosthesis-Related Infections
/
Endovascular Procedures
Type of study:
Etiology study
/
Risk factors
Limits:
Humans
Language:
Spanish
Journal:
Angiología
Year:
2012
Document type:
Article
Institution/Affiliation country:
Hospital Universitaro La Paz/España