Endovascular treatment of thoracic disease: Patient selection and a proposal of a risk score

Endovascular treatment of thoracic disease: Patient selection and a proposal of a risk score

Autor Alves, Claudia Maria Rodrigues Autor UNIFESP Google Scholar
Fonseca, José Honório Palma da Autor UNIFESP Google Scholar
Souza, José Augusto Marcondes de Autor UNIFESP Google Scholar
Carvalho, Antonio Carlos Camargo Autor UNIFESP Google Scholar
Buffolo, Enio Autor UNIFESP Google Scholar
Instituição Universidade Federal de São Paulo (UNIFESP)
Resumo Background. Although selection criteria and subgroup analysis are still in the early developmental stages, endovascular treatment of aortic disease has become an alternative to surgery for many patients.Methods. From November 1996 to November 1999, 49 patients were treated with a self-expandable endoprosthesis at our institution. Most patients had acute aortic dissections. Thirteen of these patients did not follow the anatomic selection protocol. We retrospectively analyzed these patients to compare our numerical risk score (which includes clinical and anatomic criteria) between groups with or without success and between groups that followed the anatomic protocol (P) or did not follow the anatomic protocol (E [exception]).Results. Success rates were similar in groups P and E, although mortality rates were higher in group E. Patients from group E had longer procedures and required multiple stents more frequently. the proposed risk score was able to differentiate between groups with or without success, as well as between groups P and E.Conclusions. in order to reduce mortality and morbidity rates, careful selection criteria must be followed when treating patients endovascularly. Although it is time-consuming, using objective criteria can help select patients for endovascular treatment. We propose that patients with a risk score higher than 11 should only undergo percutaneous treatment when they have an unacceptably high surgical risk, and even so only after a detailed discussion of the risks. (C) 2002 by the Society of Thoracic Surgeons.
Idioma Inglês
Data 2002-04-01
Publicado em Annals of Thoracic Surgery. New York: Elsevier B.V., v. 73, n. 4, p. 1143-1148, 2002.
ISSN 0003-4975 (Sherpa/Romeo, fator de impacto)
Editor Elsevier B.V.
Extensão 1143-1148
Fonte http://dx.doi.org/10.1016/S0003-4975(02)03386-6
Direito de acesso Acesso aberto Open Access
Tipo Artigo
Web of Science WOS:000174807400031
URI http://repositorio.unifesp.br/handle/11600/26802

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