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Vol. 57. Issue 6.
Pages 465-471 (January 2005)
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Vol. 57. Issue 6.
Pages 465-471 (January 2005)
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Complicaciones relacionadas con el injerto tras una reparación abierta de aneurisma de aorta abdominal infrarrenal
Graft-related complications following open repair of an infrarenal abdominal aortic aneurysm
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M. Baquer-Miravete
Corresponding author
margabaquer@gmail.com

Correspondencia: Servicio de Angiologíay Cirugía Vascular. Hospital de Galdakao. Barrio Labeaga, s/n. E-48960 Galdakao (Vizcaya).
, L. Estallo-Laliena, L. Rodríguez-González, M. Vega de Céniga, R. Gómez, A. Salazar, A. Barba-Vélez
Servicio de Angiologia y Cirugía Vascular. Hospital de Galdakao. Galdakao, Vizcaya.
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Resumen
Objetivo

Analizar la aparición de complicaciones relacionadas con el injerto (CRI) y su influencia en la supervivencia de los pacientes tratados mediante reparación abierta del aneurisma de aorta abdominal (AAA) infrarrenal.

Pacientes y métodos

Estudio retrospectivo desde enero 1987 a diciembre 2004. Incluye a 303 pacientes (299 varones) sometidos a reparación abierta de un AAA infrarrenal; la cirugía resultó electiva en 249 pacientes (82,2%). El seguimiento medio fue de 55,47meses (rango: 1-201meses), con control clínico anual y tomografia axial computarizada el primer, quinto y décimo año de postoperatorio. Las variables estudiadas fueron: trombosis, fístula aortoentérica, pseudoaneurisma anastomótico, infección y mortalidad, que se analizaron mediante el método de Kaplan-Meier.

Resultados

La mortalidad precoz fue del 2,8% en cirugía electiva y del 25,9% en la urgente. Durante el seguimiento fallecieron 99 pacientes (32,6%), de ellos sólo tres por CRI. La supervivencia global fue del 88,1,59,3 y 43,58% en el primer, quinto y décimo año –error estándar de la media (EEM) <3,3%–, respectivamente. Se identificaron CRI en 21 pacientes (6,9%): seis pseudoaneurismas anastomóticos, seis trombosis del injerto, seis fístulas aortoentéricas y tres infecciones del injerto. Su aparición fue precoz (≤30días) en dos pacientes (0,6%). Se reconoció la mayoría de las CRI tardías (>30días) antes de cinco años. La supervivencia libre de CRI fue del 98,1, 92,6 y 81,25% en el primer, quinto y décimo año (EEM<5%), respectivamente.

Conclusiones

En los pacientes sometidos a reparación abierta de un AAA infrarrenal puede considerarse casi innecesaria la vigilancia postoperatoria del injerto. Las CRI presentan baja incidencia y la mayoría de pacientes que sobreviven a la cirugía fallecen por otras causas.

Palabras clave:
Aneurisma de aorta abdominal
Complicaciones de injerto
Seguimiento
Supervivencia
Summary
Aims

To analyse graft-related complications (GRC) and their influence on the survival of patients treated by open repair of infrarenal abdominal aortic aneurysm (AAA).

Patients and methods

A retrospective study was conducted over the period between January 1987 and December 2004. It included 303 patients (299 males) who underwent open repair of an infrarenal AAA; surgery was elective in 249 patients (82.2%). The mean follow-up time was 55.47 months (range: 1-201), with an annual clinical control and computerised axial tomography scans at one, five and ten years after the operation. The variables taken into account in the study were thrombosis, aorto-enteric fistula, anastomotic pseudoaneurysm, infection and mortality, and they were analysed using the Kaplan-Meier method.

Results

The early mortality rate was 2.8% in elective surgery and 25.9% in cases of urgent interventions. During the follow-up there were 99 deaths (32.6%), of whom only 3. Overall survival rates were 88.1, 59.3 and 43.58% in the first, fifth and tenth year —mean standard error (MSE) >3.3%–. GRC were identified in 21 patients (6.9%): six anastomotic pseudoaneurysms, six graft thromboses, six aorto-enteric fistulae and three graft infections. Its appearance was early (<30 days) in two patients (0.6%). Most of the late GRC (<30 days) were detected within five years. GRC-free survival rate was 98.1%, 92.6% and 81.25% in the first, fifth and tenth year (MSE <5%).

Conclusions

In patients submitted to open repair of an infrarenal AAA it can be said that there is almost no need for post-operative surveillance of the graft. GRC have a low rate of incidence and most patients who survive the surgical intervention die from other causes.

Key words:
Abdominal aortic aneurysm
Follow-up
Graft complications
Survival
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Copyright © 2005. SEACV
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