KẾT QUẢ ĐIỀU TRỊ PHÌNH ĐỘNG MẠCH CHỦ BỤNG BẰNG CAN THIỆP NỘI MẠCH

Abstract

Background: Endovascular intervention for the treatment of abdominal aortic aneurysms (EVAR) is a novel method with numerous advantages over open surgery, particularly in elderly patients with multiple risk factors. Objective: To evaluate the outcomes of abdominal aortic aneurysm treatment at Cho Ray Hospital. Patients and methods: This was a descriptive cross-sectional study, combining retrospective and prospective data, conducted from June 2016 to December 2018 in the Vascular Surgery Department at Cho Ray Hospital. Results: The study included a total of 82 patients, with an average age of 73.7 ± 7.1 years, of which 64 were male. Hypertension was present in 65.9% of patients, and 69.5% were smokers. Coronary artery disease was observed in 53.7% of cases. The average length of the proximal neck was 30 ± 11.1 mm, the diameter of the proximal neck was 18.5 ± 3.2 mm, the angulation of the neck was 61.5 ± 20.3 degrees, and the mean aneurysm sac diameter was 52.25 ± 11.27 mm. The average length of the infrarenal aorta to the bifurcation was 110 ± 18.2 mm. Most procedures were elective (96.3%). Local anesthesia was the primary method of anesthesia (43.9%). Simple endovascular graft placement in the aneurysm sac was performed in 4.9% of cases, bilateral iliac artery extension in 84.2%, unilateral iliac artery extension in 11%, and block of the internal iliac arteries in 25.6% of cases. Type II endoleak was the only type and accounted for 17.1% of cases, with 3 patients experiencing mortality during follow-up. The short-term and midterm success rates were 98.7% and 96.3%, respectively. Conclusion: Endovascular intervention for the treatment of abdominal aortic aneurysms is an effective, low-complication method with rapid recovery. It is particularly suitable for elderly patients with multiple risk factors and comorbidities.