Trombo mural en endoprótesis aórticas abdominales: factores predictivos y evolución clínica

Introduction: The increase in endovascular treatment of abdominal aortic aneurysms has ledto seeing more complications, such as intraprosthesis thrombus formation, which is not without risk.Objectives: To determine the incidence of mural thrombus and the clinical course, and the factors that can directly influence its development.Material and methods: A retrospective review (July 2006-October 2011) was conducted on patients with endovascular repair of abdominal aortic aneurysms, who were monitored with computed tomographic angiography for more than 6 months. A study was made of the appearance of mural thrombus in relation to the endograft characteristics (type, material, length, ratio [R-2/ (r1(2)+ r2(2))] and internal iliac artery patency) using contingency tables, ANOVA test, and logistic regression.Results: A total of 63 cases were found, with an average follow-up of 17.43 months. The incidence of mural thrombus recorded was 22.2% (14), of which 78.6% (11) developed in the first month, and 21.4% (3) in the following 6 months. There was a higher incidence with Excluder (R) (7 of 18 [28%]) and Zenith (R) (5 of 8 [62.5%]) (P =.010), being the ratio the only predictor of thrombus formation, in both bivariate analysis (P = .001; 95% confidence interval from 0.392 to1.453) and logistic regression (P =.021; odds ratio 3.424; 95% CI 1.205 to 9.727). There were no cases of thrombus recurrence. Only one case progressed to branch thrombosis in 17 months of followup, which did not require additional intervention.Conclusions: Intra-prosthetic mural thrombus is commonly found after endovascular abdominal aortic aneurysms repair, being more associated to other types of endografts. Finding a major discrepancy area may be useful as a predictor. For early detection of thrombus, we recommenda closer monitoring with computed tomographic angiography. (C) 2012 SEACV. Published by Elsevier Espana, S. L. All rights reserved.