Endoprotesi in pazienti ad alto rischio chirurgico.

Introduction: Aim of this report was to verify the feasibility of endovascular repair of infrarenal abdominal aortic aneurysm (AAA) in high risk patients. Materials and methods: From November 1999 to December 2003, 97 patients (92 males and 5 females, mean age 76 years) with infrarenal AAA were submitted to endovascular repair. The indication to the treatment depended on local and general patients conditions. We submitted to endovascular repair all patients presenting general clinical conditions contraindicating open access (coronary insufficiency, severe chronic obstructive pulmonary disease, presence of neoplasia, previous surgical treatment). The 74% of patients were classified ASA III-IV. All patients were preoperatively studied by CTA (computer tomographic angiography). After operation, 1-3-6-12 months and each year, follow-up was performed by CTA, echocolorduplex or duplex ultrasound scan contrast. Results: Perioperative mortality was 7%, principally caused by cardiological problems; 10% of endoleaks; 10% of local complications. Mean hospital stay was 5 days. Conclusion: This report confirms endovascular repair is feasible in high risk patients with these advantages: minor invasively, reduction of intraoperative blood loss, reduction of hospital stay. The mortality was higher than open repair for the elevated presence of risk factors Key words: Stents - Blood vessel prosthesis, implantation – Aortic aneurysm, abdominal, therapy.