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AMA Citation LeMaire SA, Gopaldas RR, Coselli JS. LeMaire S.A., Gopaldas R.R., Coselli J.S. LeMaire, Scott A., et smas de la aorta torácica y. La reparación endovascular torácica (TEVAR) se ha constituido como una .. Los aneurismas de la aorta son la decimotercera causa de muerte en Casi tres cuartas partes de los aneurismas de aorta abdominal son .. Alrededor de un 25% de aneurismas aórticos degenerativos afectan a la aorta torácica.


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Agli aneurismi toraco-addominali viene invece applicata la classificazione di Crawford [5] che prevede la distinzione in: In questo caso, l'aneurisma non si estende oltre le arterie renali.


Eziologia[ modifica modifica wikitesto ] L' aterosclerosi e la necrosi cistica della tonaca media arteriosa sono le due cause maggiori per aneurisma de aorta toracica sviluppo di aneurismi aortici. Alcuni difetti genetici del tessuto connettivocome la sindrome di Marfanrappresentano una condizione di rischio per lo sviluppo di aneurismi dell'aorta toracica [7].

La compressione della vena cava superiore porta allo sviluppo di manifestazioni analoghe alla sindrome della vena cava superiorecon congestione e turgore giugulare ed edema a mantellina. Aneurisma de aorta toracica prevalence of aortic aneurysms appears to be increasing secondary to heightened awareness, improvements in imaging, and an aging population 1.

The incidence of thoracic aortic aneurysms TAA is 5.

The mean age at diagnosis ranges between years, with a male-to-female ratio of 2: Patients with thoracic aneurysms often have significant comorbidities including hypertension, coronary artery disease, chronic obstructive pulmonary disease, and congestive heart failure 3. Descending thoracic aortic aneurysms are classified into three types Fig.

Open surgery involves thoracotomy, aortic cross-clamping, aneurisma de aorta toracica major blood loss with potentially significant impacts on the heart, lung, kidneys, brain and the spinal cord. As a result, this approach is associated with significant morbidity and mortality with variable results in different centers 5—8.

Two additional devices were later approved 11 In all three pivotal trials, endovascular repair compared favorably to the traditional open repair for management of degenerative aneurysms.

Aneurisma dell'aorta toracica - Wikipedia

More complex aneurysms extending to the aortic arch vessels are now commonly treated with endovascular repair Fig. A recent systematic review and meta-analysis of comparative studies found that TEVAR, compared to open surgery, may reduce early death, paraplegia, renal insufficiency, transfusions, reoperation for bleeding, cardiac complications, pneumonia, and length of stay The aim of this review is to address some of the reported complications after this procedure.

ComplicationsMortality According to a systematic review and meta-analysis which included 42 non-randomized studies 38 comparative, 4 registries involving 5, patients, the cumulative day risk of mortality was 5.

The cumulative all-cause mortality at 1, 2, and 3 years did not differ significantly between the two groups. Although TEVAR patients were significantly older, other baseline characteristics including coronary artery disease, diabetes, chronic obstructive pulmonary disease, hypertension and renal insufficiency were not significantly different between the two groups.

Stroke Although TEVAR has a pattern of complications that are unique to endovascular procedures, perioperative stroke has a similar rate in both open aneurisma de aorta toracica endovascular interventions 6.

Aneurisma de la aorta torácica

Stroke is among the most feared and devastating complications of endovascular and open repairs of the thoracic aorta. Perioperative stroke after TEVAR may be related to systemic factors hypotension, hypertension, anticoagulationintracranial causes hemorrhage, edema, CSF drainage or emboli air, atheroma, thrombus Embolization may be related to the use and advancement of wires, catheters, and devices into a diseased aneurisma de aorta toracica aortic arch, with dislodgement of atherosclerotic plaque to the brain.

As a result, patients with a significant atherosclerotic burden and those with aneurysms close to the aortic arch are inherently at higher risk.

After reviewing these data, 3 risk factors for perioperative stroke were identified: This is likely related to lengthy manipulation of catheter, wires and devices within the aortic arch.