Emergency endovascular repair of aortoiliac aneurysms in COVID-19 times
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Rafael de Athayde Soares1, Marcus Vinícius Martins Cury1, Luiz Maurício da Silva1
1Hospital do Servidor Público Estadual de São Paulo, Division of Vascular and Endovascular Surgery, São Paulo, SP, Brasil.
Insights
Vascular emergencies, including aortic aneurysms and aortoenteric fistulas, increased during the COVID-19 pandemic. Endovascular repair proved effective for these critical conditions, with no major complications or mortality in this case series.
Area of Science:
- Vascular Surgery
- Endovascular Interventions
- Aortic Aneurysm Management
Background:
- Aortic aneurysms and related emergencies pose significant clinical challenges.
- The COVID-19 pandemic impacted healthcare, potentially altering the incidence of vascular emergencies.
- Endovascular repair is a minimally invasive option for complex aortic pathologies.
Purpose of the Study:
- To report a case series of patients presenting with aortic emergencies.
- To evaluate the efficacy of endovascular repair in managing these acute conditions.
- To highlight the trend of increased vascular emergencies during the pandemic.
Main Methods:
- Retrospective review of four consecutive patients admitted with aortic emergencies.
- Diagnosis confirmed via AngioCT-scan.
- Treatment performed using endovascular repair techniques.
Main Results:
- Four patients with ruptured aortic aneurysm, aortoenteric fistula, and iliac aneurysm were treated.
- All patients successfully underwent endovascular repair.
- No major complications or surgical mortality were observed post-procedure.
Conclusions:
- Endovascular repair is a safe and effective treatment for acute aortic emergencies.
- A rise in vascular emergencies was noted during the COVID-19 pandemic.
- Prompt endovascular intervention can lead to favorable outcomes in critical aortic conditions.
Abstract:
In this paper, we describe a case series of four patients who were admitted with emergencies related to aortic aneurysms over a 3-day period and were treated with endovascular repair. The first patient was an 81-year-old female with a history of abdominal pain and a ruptured aortic aneurysm diagnosed by AngioCT-scan. The second patient was a 63-year-old male with a history of oral digestive bleeding and an AngioCT-scan showing an aortoenteric fistula. The third patient was a 77-year-old female with sudden-onset abdominal pain and ruptured right common iliac aneurysm. The fourth patient presented with abdominal pain and an AngioCT-scan showed aortic rupture. All four patients were discharged with no major complications or surgical mortality. These case series show that despite the Covid-19 pandemic situation, since elective surgeries decreased, vascular emergencies have increased.
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