Preoperative Coil Embolization of Side Branches and Postoperative Antifibrinolytic Therapy in Endovascular Aneurysm Repair: A Propensity Score Analysis.
J Vasc Interv Radiol
; 28(4): 550-557, 2017 Apr.
Article
en En
| MEDLINE
| ID: mdl-28238579
ABSTRACT
PURPOSE:
To demonstrate feasibility and efficacy of preoperative coil embolization of side branches and postoperative tranexamic acid (TXA) therapy for management of type II endoleak and aneurysmal sac regression after endovascular aortic repair (EVAR). MATERIALS ANDMETHODS:
This study included 284 patients who underwent EVAR between 2007 and 2014. In 133 patients (group A), since March 2012, preoperative coil embolization of side branches and postoperative TXA therapy had been introduced as a modified strategy after EVAR, including combined coil embolization and TXA therapy (n = 41), coil embolization only (n = 17), and TXA therapy only (n = 75). The remaining 151 patients (group B) underwent EVAR with no coil embolization and TXA therapy. After propensity score matching, postoperative results were retrospectively compared between 92 matched pairs (group A vs group B).RESULTS:
Matched comparison revealed no significant difference in incidence rate of type II endoleak at 6 months after EVAR between group A and group B (19.6% [18/92] vs 29.4% [27/92]; P = .1172). A significantly greater shrinkage of sac size at 6 months after EVAR (-8.5% ± 11.6 vs -3.6% ± 8.4; P = .0011) and significantly more rapid pace of sac shrinkage (change of size per year; -4.2 mm/y ± 7.6 vs -1.9 mm/y ± 6.1; P = .0301) were observed in group A.CONCLUSIONS:
Combined preoperative coil embolization of side branches and postoperative TXA therapy were associated with significantly more rapid aneurysmal sac regression after EVAR.
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Ácido Tranexámico
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Terapia Trombolítica
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Aneurisma de la Aorta Abdominal
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Implantación de Prótesis Vascular
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Embolización Terapéutica
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Procedimientos Endovasculares
/
Fibrinolíticos
Tipo de estudio:
Etiology_studies
/
Observational_studies
/
Risk_factors_studies
Límite:
Aged
/
Aged80
/
Female
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Humans
/
Male
Idioma:
En
Revista:
J Vasc Interv Radiol
Asunto de la revista:
ANGIOLOGIA
/
RADIOLOGIA
Año:
2017
Tipo del documento:
Article