Context: Abdominal aortic aneurysm (AAA) is a condition that is usually asymptomatic, but potentially fatal, and has a prevalence in men over 60 years old ranging from 4.3% to 8%. There are two treatment options available: open surgery (OS) and endovascular treatment (ET). Objective: To compare the results of repairs conducted using these two treatment methods from 2008 to 2013 in a tertiary hospital. Methods: A retrospective analysis comparing 119 patients treated with OS and 219 patients who underwent ET for AAA repair. Results: The ET group was older (71.3 vs. 68.2 years; p<0.001) and had a higher rate of coronary disease (44.7% vs. 27.7%; p=0.002) and a lower ejection fraction (57.6% vs. 64.3%; p<0.001); in turn, the OS group had more chronic obstructive pulmonary disease (16.0% vs. 5.9%; p=0.004) and a smaller proximal infrarenal neck (15.5 mm vs. 23.0 mm; p<0.001). However, there was no difference in ASA classification (American Society of Anesthesiology) (p=0.36). The ET group had less intraoperative bleeding (171 mL vs. 729 mL; p<0.001) and required fewer blood transfusions (11.9% vs. 73.1% p<0.001), and spent shorter stays in both ICU (2.4 vs. 3.5 days; p=0.002) and hospital (5.8 vs. 10.3 days; p<0.001). Thirty-day mortality was similar (OS 5.0% vs. ET 4.1%; p=0.78) and there was also no difference in postoperative complications. The average cost of ET was higher (R$34,277.76 vs. R$4,778.60; p<0.001). Conclusions: Rates of morbidity and mortality were similar, although ET was associated with less bleeding, fewer transfusions and shorter hospital stays, but was more expensive. ResumoContexto: O aneurisma de aorta abdominal (AAA) é uma condição frequentemente assintomática, porém potencialmente fatal, cuja prevalência em homens com 60 anos ou mais está entre 4,3% e 8%. Existem duas modalidades de tratamento disponíveis: cirurgia aberta (TA) e endovascular (TE). Objetivo: Comparar os resultados dessas duas modalidades de tratamento, entre 2008 e 2013, em um hospital terciário. Métodos: Análise retrospectiva comparando 119 pacientes submetidos ao TA e 219 pacientes submetidos ao TE, para correção de AAA. Resultados: O grupo submetido ao TE apresentou maior idade (71,3 vs. 68,2 anos; p<0,001) e doença coronariana (44,7% vs. 27,7%; p=0,002), além de menor fração de ejeção (57,6% vs. 64,3%; p<0,001); por sua vez, o grupo submetido ao TA exibiu mais doença pulmonar obstrutiva crônica (16,0% vs. 5,9%; p=0,004) e menor colo proximal infrarrenal (15,5 mm vs. 23,0 mm; p<0,001). Entretanto, não houve diferença na classificação ASA (American Society of Anesthesiology) (p=0,36). O grupo de TE apresentou menor sangramento intraoperatório (171 mL vs. 729 mL; p<0,001), com menor necessidade de hemotransfusão (11,9% vs. 73,1% p<0,001), menor permanência em UTI (2,4 vs. 3,5 dias; p=0,002) e menor tempo de internação hospitalar (5,8 vs. 10,3 dias; p<0,001). A mortalidade em 30 dias foi semelhante (TA 5,0% vs. TE 4,1%; p=0,78), também não havendo diferença nas complicações pós-operatórias. O custo médio do TE foi maior (R$34....

Background: With the recent advances in endovascular techniques and the emergence of more flexible endoprosthesis, the treatment of popliteal artery aneurysms has become more frequent. The objective of this study was to evaluate the short and mid-term clinical outcomes of the treatment of popliteal artery aneurysms with the use of a flexible endoprosthesis. Methods: Retrospective longitudinal study conducted in two sites from January of 2011 to February of 2014. Populational characteristics, procedure-related data, and radiologic imaging were evaluated at a mean follow-up of 1 year. Morbidity and mortality rates, complication rates, and stent patency rates were obtained. Results: A total of 13 male patients, mean age 66 ± 9 years, were submitted to popliteal artery aneurysm treatment in 15 limbs. Run-off vessel evaluation showed that most patients had at least two patent arteries in the legs (92.3%). Stents were implanted in the middle segment in 57.1% and in the distal segment of the popliteal artery in 42.9% of the procedures. Target lesion revascularization was achieved in all of the cases and two stents were required in four limbs. Seventeen Viabahn™ and two Multilayer™ stents were used. During the 12-month follow-up there were no stent fractures. The primary patency rate was 53.3% and limb salvage rate was 100%. Conclusions: Endovascular treatment of popliteal artery aneurysm was shown to be effective in the mid-term follow-up.

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