Segurança da embolização pré-operatória do ramo em pacientes submetidos a evar

Suárez González, Luis Ángel; Martínez-Luengas, Iñigo Lozano; del Canto Peruyera, Pablo; Vallina-Victorero Vazquez, Manuel Javier

Acessibilidade / Reportar erro

Brasil

Jornal Vascular Brasileiro

Español English

Brasil

Español English

sumário « anterior atual seguinte »

Sumário

REVIEW ARTICLE • J. Vasc. Bras. 23 • 2024 • https://doi.org/10.1590/1677-5449.202201372 copiar

Segurança da embolização pré-operatória do ramo em pacientes submetidos a evar

Autoria SCIMAGO INSTITUTIONS RANKINGS

Resumo

O objetivo desta revisão sistemática foi avaliar a segurança da embolização de artéria mesentérica inferior (AMI) e artérias lombares (ALs) pré-correção endovascular de aneurisma da aorta abdominal. Foram realizadas pesquisas nas bases de dados MEDLINE e Dimensions. Foram encontrados 9 estudos publicados de 2011 a 2021 que atendiam aos critérios de inclusão e exclusão. Os estudos foram analisados para definir a incidência de complicações relacionadas à embolização. No total, 482 pacientes foram submetidos a embolização de AMI e/ou ALs, dos quais 30 (6,2%) sofreram algum tipo de complicação menor. A única complicação importante observada foi colite isquêmica em 4 (0,82%) pacientes. Dois (0,41%) desses pacientes morreram após cirurgia de ressecção intestinal. Em relação a esses achados, a embolização de AMI e ALs parece ser um procedimento seguro, com um percentual muito baixo de complicações menores e importantes.

Palavras-chave:
EVAR; artéria mesentérica inferior; artérias lombares; embolização

Author (year)	Access site	Embolization method	Timing of embolization
Burbelko et al.¹⁵15 Burbelko M, Kalinowski M, Heverhagen JT, et al. Prevention of Type II endoleak using the AMPLATZER vascular plug before endovascular aneurysm repair. Eur J Vasc Endovasc Surg. 2014;47(1):28-36. http://dx.doi.org/10.1016/j.ejvs.2013.10.003. PMid:24183247. http://dx.doi.org/10.1016/j.ejvs.2013.10...	Transfemoral	Amplatzer Vascular plug	Pre-EVAR (1-4 weeks)
Aoki et al.¹⁶16 Aoki A, Maruta K, Hosaka N, Masuda T, Omoto T, Horikawa Y. Predictive factor of the possibility for aortic side branches coil embolization during endovascular abdominal aortic aneurysm repair. Ann Vasc Dis. 2020;13(3):240-7. http://dx.doi.org/10.3400/avd.oa.20-00115. PMid:33384725. http://dx.doi.org/10.3400/avd.oa.20-0011...	Transfemoral	Coils	During EVAR
Alerci et al.¹⁷17 Alerci M, Giamboni A, Wyttenbach R, et al. Endovascular abdominal aneurysm repair and impact of systematic preoperative embolization of collateral arteries: endoleak analysis and long-term follow-up. J Endovasc Ther Off J Int Soc Endovasc Spec. 2013;20(5):663-71. http://dx.doi.org/10.1583/12-4188MR.1. PMid:24093319. http://dx.doi.org/10.1583/12-4188MR.1...	Transfemoral	Coils	Pre-EVAR (15 days)
Petit et al.¹⁸18 Petit P, Hertault A, Mesnard T, et al. Outcomes of preventive embolization of the inferior mesenteric artery during endovascular abdominal aortic aneurysm repair. J Vasc Interv Radiol. 2021;32(9):1360-1370.e2. http://dx.doi.org/10.1016/j.jvir.2021.05.023. PMid:34087358. http://dx.doi.org/10.1016/j.jvir.2021.05...	Transfemoral	Coils, Amplatzer Vascular plug	During EVAR
Branzan et al.¹⁹19 Branzan D, Geisler A, Steiner S, et al. Type II endoleak and aortic aneurysm sac shrinkage after preemptive embolization of aneurysm sac side branches. J Vasc Surg J (NY). 2021;73(6):1973-1979.e1. PMid:33278537.	Transfemoral	Vascular plug, coils	Pre-EVAR
	Transfemoral		During EVAR
	Transbrachial (if acute downward angulation of the IMA)		During EVAR
Müller-Wille et al.²⁰20 Müller-Wille R, Uller W, Gössmann H, et al. Inferior mesenteric artery embolization before endovascular aortic aneurysm repair using amplatzer vascular plug type 4. Cardiovasc Intervent Radiol. 2014;37(4):928-34. http://dx.doi.org/10.1007/s00270-013-0762-4. PMid:24170169. http://dx.doi.org/10.1007/s00270-013-076...	Transfemoral	Amplatzer Vascular plug	Pre-EVAR
	Transbrachial	Amplatzer Vascular plug	Pre-EVAR
Ward et al.²¹21 Ward TJ, Cohen S, Fischman AM, et al. Preoperative inferior mesenteric artery embolization before endovascular aneurysm repair: decreased incidence of type II endoleak and aneurysm sac enlargement with 24-month follow-up. J Vasc Interv Radiol JVIR. 2013;24(1):49-55. http://dx.doi.org/10.1016/j.jvir.2012.09.022. PMid:23273697. http://dx.doi.org/10.1016/j.jvir.2012.09...	Transfemoral	Coils	Pre-EVAR (4-8 weeks)
Vaillant et al.²²22 Vaillant M, Barral PA, Mancini J, et al. Preoperative inferior mesenteric artery embolization is a cost-effective technique that may reduce the rate of aneurysm sac diameter enlargement and reintervention after EVAR. Ann Vasc Surg. 2019;60:85-94. http://dx.doi.org/10.1016/j.avsg.2019.03.012. PMid:31200030. http://dx.doi.org/10.1016/j.avsg.2019.03...	Transfemoral	Coils (IMA <5 mm)	Pre- EVAR (24-72h)
	Transfemoral	Amplatzer Vascular plug (IMA <5mm)	Pre- EVAR (24-72h)
Manunga et al.²³23 Manunga JM, Cragg A, Garberich R, et al. Preoperative inferior mesenteric artery embolization: a valid method to reduce the rate of type II endoleak after EVAR? Ann Vasc Surg. 2017;39:40-7. http://dx.doi.org/10.1016/j.avsg.2016.05.106. PMid:27531083. http://dx.doi.org/10.1016/j.avsg.2016.05...	Transfemoral	Coils	During EVAR

Author	Level of evidence	Patients (n)	Type of study	Target vessels	Minor complications	Major complications
Burbelko et al.¹⁵15 Burbelko M, Kalinowski M, Heverhagen JT, et al. Prevention of Type II endoleak using the AMPLATZER vascular plug before endovascular aneurysm repair. Eur J Vasc Endovasc Surg. 2014;47(1):28-36. http://dx.doi.org/10.1016/j.ejvs.2013.10.003. PMid:24183247. http://dx.doi.org/10.1016/j.ejvs.2013.10...	2b	40	Retrospective cohort	IMA, LA	0	0
Aoki et al.¹⁶16 Aoki A, Maruta K, Hosaka N, Masuda T, Omoto T, Horikawa Y. Predictive factor of the possibility for aortic side branches coil embolization during endovascular abdominal aortic aneurysm repair. Ann Vasc Dis. 2020;13(3):240-7. http://dx.doi.org/10.3400/avd.oa.20-00115. PMid:33384725. http://dx.doi.org/10.3400/avd.oa.20-0011... (2017)	2b	24	Retrospective cohort	IMA, LA	0	0
Alerci et al.¹⁷17 Alerci M, Giamboni A, Wyttenbach R, et al. Endovascular abdominal aneurysm repair and impact of systematic preoperative embolization of collateral arteries: endoleak analysis and long-term follow-up. J Endovasc Ther Off J Int Soc Endovasc Spec. 2013;20(5):663-71. http://dx.doi.org/10.1583/12-4188MR.1. PMid:24093319. http://dx.doi.org/10.1583/12-4188MR.1...	2b	39	Retrospective cohort	IMA, LA	0	0
Petit et al.¹⁸18 Petit P, Hertault A, Mesnard T, et al. Outcomes of preventive embolization of the inferior mesenteric artery during endovascular abdominal aortic aneurysm repair. J Vasc Interv Radiol. 2021;32(9):1360-1370.e2. http://dx.doi.org/10.1016/j.jvir.2021.05.023. PMid:34087358. http://dx.doi.org/10.1016/j.jvir.2021.05...	2b	52	Retrospective cohort	IMA	0	2 IC
Branzan et al.¹⁹19 Branzan D, Geisler A, Steiner S, et al. Type II endoleak and aortic aneurysm sac shrinkage after preemptive embolization of aneurysm sac side branches. J Vasc Surg J (NY). 2021;73(6):1973-1979.e1. PMid:33278537.	4	139	Retrospective case series	IMA, LA	16 moderate back pain	1 IC (1 death)
Müller-Wille et al.²⁰20 Müller-Wille R, Uller W, Gössmann H, et al. Inferior mesenteric artery embolization before endovascular aortic aneurysm repair using amplatzer vascular plug type 4. Cardiovasc Intervent Radiol. 2014;37(4):928-34. http://dx.doi.org/10.1007/s00270-013-0762-4. PMid:24170169. http://dx.doi.org/10.1007/s00270-013-076...	4	31	Retrospective case series	IMA	2 hematoma	0
Ward et al.²¹21 Ward TJ, Cohen S, Fischman AM, et al. Preoperative inferior mesenteric artery embolization before endovascular aneurysm repair: decreased incidence of type II endoleak and aneurysm sac enlargement with 24-month follow-up. J Vasc Interv Radiol JVIR. 2013;24(1):49-55. http://dx.doi.org/10.1016/j.jvir.2012.09.022. PMid:23273697. http://dx.doi.org/10.1016/j.jvir.2012.09...	2b	108	Retrospective cohort	IMA	10 abdominal pain	1 IC (1 death)
Vaillant et al.²²22 Vaillant M, Barral PA, Mancini J, et al. Preoperative inferior mesenteric artery embolization is a cost-effective technique that may reduce the rate of aneurysm sac diameter enlargement and reintervention after EVAR. Ann Vasc Surg. 2019;60:85-94. http://dx.doi.org/10.1016/j.avsg.2019.03.012. PMid:31200030. http://dx.doi.org/10.1016/j.avsg.2019.03...	2b	37	Retrospective cohort	IMA	2 hematoma	0
Manunga et al.²³23 Manunga JM, Cragg A, Garberich R, et al. Preoperative inferior mesenteric artery embolization: a valid method to reduce the rate of type II endoleak after EVAR? Ann Vasc Surg. 2017;39:40-7. http://dx.doi.org/10.1016/j.avsg.2016.05.106. PMid:27531083. http://dx.doi.org/10.1016/j.avsg.2016.05...	4	12	Retrospective cohort	IMA	0	0

Sociedade Brasileira de Angiologia e de Cirurgia Vascular (SBACV) Rua Estela, 515, bloco E, conj. 21, Vila Mariana, CEP04011-002 - São Paulo, SP, Tel.: (11) 5084.3482 / 5084.2853 - Porto Alegre - RS - Brazil
E-mail: secretaria@sbacv.org.br

Acompanhe os números deste periódico no seu leitor de RSS

[1] Conflicts of interest: No conflicts of interest declared concerning the publication of this article.