¿Cómo influye la cirugía endovascular en el diámetro del cuello aórtico?

Summary. Introduction. The variation in the diameter of the proximal aortic neck (PAN) of an abdominal aortic aneurysm (AAA) following endovascular surgery (EVS) is a matter of some controversy. Aims. To assess the changes in the diameter of the PAN after EVS and to compare groups of patients with different degrees of PAN dilatation. Patients and methods. We conducted an observation-based study of cases and controls between January 1999 and December 2006. A total of 75 patients with asymptomatic, arteriosclerotic AAA treated by means of EVS underwent surgery in our department; juxta/suprarenal, symptomatic, fissured and inflammatory patients were excluded. Data were collected on variables such as cardiovascular risk factors and comorbidity, as well as variables related to the morphology of the AAA and the type of stent used, both before the EVS and in the last post-operative control visit. Patients with PAN dilatation were divided into groups according to whether the dilatation was below or above 15% ('high risk'). Results. PAN dilatation was observed in 59 patients (72%) after a mean follow-up time of 24 months; this dilatation was classified as 'high risk' in 34% of cases. In these patients the follow-up time was longer than in the rest of the sample, and the difference was statistically significant (p < 0.05). Conclusions. PAN dilatation occurred in 72% of the patients with AAA treated by means of EVS; in a third of them, the dilatation was greater than 15%, and this was not related to a higher rate of complications. The follow-up time after surgery is a variable that is related with this dilatation. [ANGIOLOGÍA 2008; 60: 327-32]