Manejo del aneurisma de la aorta abdominal: Estado actual, evidencias y perspectivas para el desarrollo de un programa nacional

• Leopoldo Mariné M ^[1] ; Francisco Valdés E ^[1] ; Renato Mertens M ^[1] ; Albrecht Krämer Sch ^[1] ; Michel Bergoeing R ^[1] ; Dixiana Rivera D ^[2] ; Jeanette Vergara G ; Claudia Carvajal N
  1. [1] Pontificia Universidad Católica de Chile

     Pontificia Universidad Católica de Chile

     Santiago, Chile

     
  2. [2] Instituto Vascular de Santiago
• Localización: Revista Médica de Chile, ISSN-e 0034-9887, Vol. 137, Nº. 8, 2009, págs. 1081-1088
• Idioma: español
• Títulos paralelos:
  • Open and endovascular surgery for the treatment of abdominal aortic aneurism: Review of the available evidence
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• Resumen

  • Open and endovascular surgery are therapeutic alternatives for the treatment of abdominal aortic aneurism. The development of guidelines for its treatment requires a thorough analysis of available evidence to recommend the best treatment for each country's reality. Prospective randomized trials have shown best initial results with endovascular surgery, with higher hospital costs than open surgery. The requirement of anatomical suitability for the placement of endovascular prostheses limits the universal use of endovascular surgery. Moreover, this type of surgery needs a strict imaging and clinical follow up due to the high rates of late complications, which range from 20% to 40%. Many of these complications require further surgical interventions, elevating costs of treatment. The initial benefit of endovascular surgery is lost during long follow up as survival curves become similar to those of open surgery. Even for patients with a high surgical risk, the benefits of endovascular surgery are doubtful.