혈관 내 치료 시대에 복부 대동맥류의 수술적 치료의 적응과 단기 치료 성적
Indications and Short-term Results of Open Surgical Repair of Abdominal Aortic Aneurysm in an Endovascular Era
노영남, 박양진, 김동익, 박광보, 도영수, 최승혁, 김덕경, 김영욱,
소속 상세정보
노영남 ( Roh Young-Nam )
성균관대학교 의과대학 삼성서울병원 혈관외과
박양진 ( Park Yang-Jin )
성균관대학교 의과대학 외과학교실
김동익 ( Kim Dong-Ik )
성균관대학교 의과대학 삼성서울병원 외과학교실
박광보 ( Park Kwang-Bo )
성균관대학교 의과대학 삼성서울병원 영상의학과
도영수 ( Do Young-Soo )
성균관대학교 의과대학 삼성서울병원 영상의학과
최승혁 ( Choi Seung-Hyuk )
성균관대학교 의과대학 순환기내과학교실
김덕경 ( Kim Duk-Kyung )
성균관대학교 의과대학 삼성서울병원 순환기내과
김영욱 ( Kim Young-Wook )
성균관대학교 의과대학 삼성서울병원 외과학교실
KMID : 0371320110800030212
Abstract
Purpose: To assess the role of OR in treatment of AAA patients, we reviewed the indications and our current results of OR of AAA.
Methods: We retrospectively investigated the database of 366 patients (mean age, 68.3±8.7 years, male 86%) who underwent open surgical (n=291, 80%) or endovascular treatments (n=75, 20%) of AAA in a tertiary referral center between Sep. 2003 to Aug. 2010. Treatment-related morbidities and mortality rates within 30 days were investigated according to the indications for treatment, clinical features, anatomic location, and underlying causes of AAA.
Results: According to the location of AAA, we treated 343 (94%) infrarenal, 17 (5%) juxtarenal and 6 (2%) suprarenal AAAs. Underlying causes of AAA were degenerative (90%), infected (3%), inflammatory (3%), Marfan’s syndrome (2%), and vasculitis (0.5%). Clinically, 338 (92%) were non-ruptured and 28 (8%) were ruptured AAAs. 75% of patients were treated with OR after the inception of reimbursement of aortic device while 25% of patients were treated with EVARs. The operative mortality rates of OR was 0.4% in patients with non-ruptured infrarenal AAA, 0% in patients with non-ruptured juxta- and suprarenal AAA and 21.4% in ruptured AAA patients.
Conclusion: In an era of endovascular treatment of AAA, we have experienced excellent surgical results after OR in patients with non-ruptured AAA with various clinical features. Though EVAR is rapidly replacing OR in treatment of infrarenal AAAs, OR has its own role in treatment of AAA patients with unfavorable conditions for EVAR. The role of OR should not be underestimated.
키워드
복부 대동맥류; 수술적 치료; 결과
Abdominal aortic aneurysm; Surgical repair; Outcomes
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