Advanced Search

Home > Journals > Italian Journal of Vascular and Endovascular Surgery > Past Issues > Giornale Italiano di Chirurgia Vascolare 2002 March;9(1) > Giornale Italiano di Chirurgia Vascolare 2002 March;9(1):65-80

ISSUES AND ARTICLES   MOST READ   eTOC

CURRENT ISSUEITALIAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY

A Journal on Vascular and Endovascular Surgery


Official Journal of the Italian Society of Vascular and Endovascular Surgery
Indexed/Abstracted in: EMBASE, Scopus

 

Giornale Italiano di Chirurgia Vascolare 2002 March;9(1):65-80

 ORIGINAL ARTICLES

Thoracoabdominal aortic aneurysm surgery. Personal experience

Odero A., Pirrelli S., Arici V., De Troia A., Lovotti M.

From the Vas­cular Sur­gery Divi­sion IRCCS Pol­i­clinico S. ­Matteo - ­Pavia Uni­ver­sity - Pavia

Back­ground. The sur­gical ­repair of thor­a­coab­dom­inal aneu­rysms ­presents ­early and ­late com­pli­ca­tions ­related to ­organ com­pli­ca­tions ­like ­renal ­failure, par­a­par­esis/par­a­plegia and ­multi-­organ ­failure (MOF).
­Methods. Out of a ­total 1377 oper­ated ­aortic aneu­rysms ­over a 10-­year ­period, we ­made a ret­ro­spec­tive ­study of 79 ­cases of thor­a­coab­dom­inal aneu­rysms. ­Patients ­showed the fol­lowing dis­tri­bu­tion pat­tern in ­terms of ana­tomic-sur­gical exten­sion: 22 (28%) ­type 1, 31 (40%) ­type 2, 14 (18%) ­type 3 and 12 (14%) ­type 4 ­according to ­Crawford’s clas­sifi­ca­tion. A ­total of 20 ­cases under­went emer­gency sur­gery (25%), 15 (15.6%) ­with rup­ture and 5 (5.2%) ­with fis­su­ra­tion of the aneu­rysm. By ­dividing the ­study ­period ­into two 5-­year ­phases (1991-1995: 33 ­patients, and 1996-2001: 46 ­patients), the mor­tality ­rate for elec­tive sur­gery ­fell ­from 30% in the ­first ­period to 8% in the ­second. The mor­tality ­rate for emer­gency sur­gery ­remained ­high ­over ­both ­periods: 60%.
­Results. Uni­var­iate anal­ysis (χ2 ­test and ­Mann ­Whitney’s U ­test) ­showed a sig­nif­i­cant cor­re­la­tion ­between the out­come of sur­gery and the ­type of admis­sion (p=0.01), ­female sex (p<0.04), pre-­existing hyper­ten­sion (p=0.03) and ­clamping ­time (p<0.04).
Con­clu­sions. ­From a ­review of the lit­er­a­ture and in ­view of ­these ­results, it is ­clear ­that ­organ pro­tec­tion in thor­a­coab­dom­inal ­aortic ­repair ­still rep­re­sents a ­major ­obstacle in ­terms of mor­tality and mor­bidity ­which is ­open to ­major new devel­op­ments.

language: English, Italian


FULL TEXT  REPRINTS

top of page