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

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dc.contributor.authorAlves, Claudia Maria Rodrigues [UNIFESP]
dc.contributor.authorFonseca, José Honório Palma da [UNIFESP]
dc.contributor.authorSouza, José Augusto Marcondes de [UNIFESP]
dc.contributor.authorCarvalho, Antonio Carlos Camargo [UNIFESP]
dc.contributor.authorBuffolo, Enio [UNIFESP]
dc.contributor.institutionUniversidade Federal de São Paulo (UNIFESP)
dc.date.accessioned2016-01-24T12:33:19Z
dc.date.available2016-01-24T12:33:19Z
dc.date.issued2002-04-01
dc.description.abstractBackground. 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.en
dc.description.affiliationUniversidade Federal de São Paulo, Paulista Sch Med, São Paulo, Brazil
dc.description.affiliationUnifespUniversidade Federal de São Paulo, Paulista Sch Med, São Paulo, Brazil
dc.description.sourceWeb of Science
dc.format.extent1143-1148
dc.identifierhttp://dx.doi.org/10.1016/S0003-4975(02)03386-6
dc.identifier.citationAnnals of Thoracic Surgery. New York: Elsevier B.V., v. 73, n. 4, p. 1143-1148, 2002.
dc.identifier.doi10.1016/S0003-4975(02)03386-6
dc.identifier.issn0003-4975
dc.identifier.urihttp://repositorio.unifesp.br/handle/11600/26802
dc.identifier.wosWOS:000174807400031
dc.language.isoeng
dc.publisherElsevier B.V.
dc.relation.ispartofAnnals of Thoracic Surgery
dc.rightsinfo:eu-repo/semantics/openAccess
dc.rights.licensehttp://www.elsevier.com/about/open-access/open-access-policies/article-posting-policy
dc.titleEndovascular treatment of thoracic disease: Patient selection and a proposal of a risk scoreen
dc.typeinfo:eu-repo/semantics/article
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