Reparación endovascular de aneurismas aórticos complejos: comparación entre endoprótesis modificadas por el cirujano y dispositivos ramificados comerciales en un centro de alta complejidad

Roger Conde Moncada; Luis Mariano Ferreira; Ricardo  La Mura; Oscar Dávila; W. Samir  Cubas

doi:10.47487/apcyccv.v6i4.544

Authors

Roger Conde Moncada Servicio de Cirugía Cardiovascular y Endovascular, Instituto Cardiovascular del Perú, Lima, Perú. https://orcid.org/0000-0002-2215-4524
Luis Mariano Ferreira Servicio de Cirugía Vascular y Endovascular, Clínica Sagrada Familia, Buenos Aires, Argentina. https://orcid.org/0000-0002-2530-783X
Ricardo La Mura Servicio de Cirugía Vascular y Endovascular, Clínica Sagrada Familia, Buenos Aires, Argentina. https://orcid.org/0000-0002-0046-6201
Oscar Dávila Servicio de Cirugía Vascular y Endovascular, Clínica Sagrada Familia, Buenos Aires, Argentina.
W. Samir Cubas Departamento de Cirugía Cardiovascular, London Health Sciences Centre, London, Canadá. https://orcid.org/0000-0002-5380-7372

DOI:

https://doi.org/10.47487/apcyccv.v6i4.544

Keywords:

Aortic Aneurysm Thoracoabdominal, Endovascular Aneurysm Repair, Hospital Mortality

Abstract

Objective. Endovascular treatment of complex thoracoabdominal and paravisceral aortic aneurysms represents one of the most demanding challenges in endovascular surgery, driven by the development of new devices. This study aimed to describe the 30-day perioperative mortality, major postoperative complications, and reinterventions in patients treated for complex aortic aneurysms using off-the-shelf branched endografts (t-BRANCH) and Physician-Modified Endografts (PMEGs). Materials and Methods. This was a single-center, retrospective, observational study based on a prospectively collected database including all patients treated for complex aortic aneurysms and recorded in their medical records at our reference aortic center between January 2020 and December 2024. Results. A total of 51 patients were analyzed, with a mean age of 69.6 ± 10.3 years; 90.2% were male. The mean aneurysm diameter was 66.1 ± 15.2 mm. Overall mortality was 9.8%, with early in-hospital mortality of 23.1% in the T-Branch group compared to 5.3% in the PMEG group (p = 0.0977). Predictors of in-hospital mortality included an American Society of Anesthesiologists (ASA) physical status classification of IV (OR = 11.98; 95% CI: 1.46–98.7; p = 0.022) and a history of stroke (OR = 13.07; 95% CI: 1.06–161.5; p = 0.043). Conclusions. Endovascular repair of complex aortic aneurysms using PMEGs and t-BRANCH devices shows favorable results with respect to mortality and major postoperative complications associated with a low rate of reinterventions.

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