Akut aort transeksiyonlarının endovasküler tedavisinde başarıyı etkileyen faktörler

Özlem Balcıoğlu; Sedat Karaca; Mustafa Parıldar; Ümit Kahraman; Hakan Posacıoğlu

doi:10.19161/etd.1166899

TR EN

Akut aort transeksiyonlarının endovasküler tedavisinde başarıyı etkileyen faktörler

Öz

Amaç: Bu çalışmada Akut Aort Transeksiyonu tanısıyla 2002 – 2018 yılları arasında endovasküler tedavi ile tedavi edilmiş hastaların sonuçları ve başarıyı etkileyebilecek faktörleri sunmak amaçlanmıştır. Gereç ve Yöntem: Çalışmaya toplam 17 hasta dahil edilmiş olup retrospektif olarak planlanmıştır. Hastaların tüm verilerine dosyaları taranarak ulaşılmış ve tüm hastaların demografik verileri kaydedilmiştir. Çalışmaya dahil edilen tüm hastalardan yazılı onam belgesi alınmıştır. Hastaların travma şekilleri ve cinsiyet oranları yüzdelik olarak hesaplanmıştır. Kesin tanı için kontrastlı torakoabdominal bilgisayarlı tomografi çekilerek endovasküler tedavi açısından değerlendirme yapılmıştır. Endovasküler tedaviye uygun görülen tüm hastalara ilk 24 saat içinde müdahale edilmiştir. Bulgular: Çalışmamıza dahil edilen hasta grubunun evrelemesinde büyük çoğunluğu evre 4 hastalar oluşturmakta olup etiyolojide en büyük sebebin araç içi trafik kazaları olduğu göze çarpmaktadır. Çalışmaya dahil edilen 17 hastanın 2’si erken dönemde 1’i takip sürecinde kaybedilmiştir. Endovasküler tedavinin komplikasyonları olarak bilinen greftte migrasyon, psödoanevrizma ve greftte kıvrılma gibi komplikasyonlar ile karşılaşılmamıştır. On yedi hastanın 12’sinde sol subklaviyen arter kapatılmış olmasına rağmen sadece ikisine karotis – subklaviyen baypas uygulama ihtiyacı oluşmuştur. Sonuç: Konvansiyonel cerrahiye oranla endovasküler tedavinin düşük mortalite ile uygulanabiliyor olması akut aort transeksiyonlarında mortaliteyi azaltmaktadır. Müdahalenin ilk 24 saatte, bu konuda deneyimli merkezlerde yapılması ve greft seçiminde aort çapının %10’unun aşılmaması, balon dilatasyonundan kaçınılması tedavi başarısını etkileyen en önemli faktörlerdendir.

Anahtar Kelimeler

Factors affecting success in endovascular treatment of acute aortic transections

Abstract

Aim: In this study, it was aimed to present the results of patients treated with endovascular treatment between 2002 and 2018 with the diagnosis of Acute Aortic Transection and the factors that may affect the success. Materials and Methods: A total of 17 patients were included in the study and it was planned as retrospectively. All data of the patients were collected by file searching method and demographic features of the patients were recorded. Written informed consent was obtained from all patients prior to study. Trauma types and gender ratios of the patients were calculated as percentages.. Contrast-enhanced thoraco-abdominal computed tomography was performed for definitive diagnosis, and endovascular treatment was evaluated. All patients deemed suitable for endovascular treatment were intervened within the first 24 hours. Results: The most majority of our patient group was in stage 4 and the most common etiology was recorded as in - vehicle traffic accidents. Of the 17 patients included in the study, 2 died in the early period and 1 died in the follow-up period. Complications such as graft migration, pseudo aneurysm and graft kinking, which are known as complications of endovascular treatment, were not encountered. Although the left subclavian artery was closed in 12 of 17 patients, only two of them required carotid-subclavian bypass. Conclusion: The fact that endovascular treatment can be applied with low mortality compared to conventional surgery reduces mortality in acute aortic transections. The most important factors affecting the success of the treatment are that the intervention is performed in the 24 hours, in experienced centers, and that 10% of the aortic diameter is not exceeded in the graft selection, and balloon dilatation is avoided.

Keywords

References

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Details

Primary Language

Turkish

Subjects

Health Care Administration

Journal Section

Research Article

Authors

Özlem Balcıoğlu ^*
0000-0002-8935-1477
Türkiye

Sedat Karaca
0000-0001-6761-2122
Türkiye

Mustafa Parıldar
0000-0002-1037-8483
Türkiye

Ümit Kahraman
0000-0003-0194-5746
Türkiye

Hakan Posacıoğlu
0000-0002-1949-0471
Türkiye

Publication Date

September 12, 2022

Submission Date

October 26, 2021

Acceptance Date

January 17, 2022

Published in Issue

Year 2022 Volume: 61 Number: 3

DOI

https://doi.org/10.19161/etd.1166899

IZ

https://izlik.org/JA25GA54TR

Cite

RIS / Bibtex

Vancouver

1.Özlem Balcıoğlu, Sedat Karaca, Mustafa Parıldar, Ümit Kahraman, Hakan Posacıoğlu. Akut aort transeksiyonlarının endovasküler tedavisinde başarıyı etkileyen faktörler. EJM. 2022 Sep. 1;61(3):326-33. doi:10.19161/etd.1166899

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