|LONG TERM PREVENTION OF VASCULAR EVENTS DUE TO AORTIC ANEURYSMS
M. Dilić, S. Pehar, S.Kazić, O.Terzić and U.Šalaka.
of Vascular Diseases, Clinical Center University of Sarajevo,
Bosnalijek, Sarajevo, Bosnia and Herzegovina
patients with aortic aneurysms of various type (Type A, B or C
aacording to DeBakey), especially with lumen diameter over 5,00
cm and ulcerous arterial inner wall, have constant and imminent
danger of embolic vascular events (EVE). Atherosclerosis as a
systemic, multifocal disease, has multisegmental stenotic changes
of various arterial segments as a pre-existing asymptomatic disease.
Aim of this article is to compared various antithrombotics and
its relationship with EVE, i.e. embolic complications. Method:
we enrolled a group of pts.with aortic aneurysms (Type C), total
of 47 pts. (29 male, and 10 females, with average age of 69 yrs.
with SD of 11,4). All of them had a long term antithrombotic therapy,
(i) 23 pts. with acetylsalicilacid (ASA) 100 mg/day, (ii) 14 pts.
with clopidogrel 75 mg/day + ASA 100 mg/day (Bospyrin), (iii)
and 10 pts. with clopidogrel 75 mg/day, alone. Follow-up started
36 months ago, with average follow-up period of 19 months. Results:
our group had a total of 47 pts. with type C of aortic aneurysms.
An average lumen diameter (LD) was 5,9 cm. In the follow-up period
there was a 5 EVE (10,6%), embolic complications due to mobilisation
of emboli to distal vascular segments, 1 to iliaco-femoral segment,
1 to popliteo-tibial segment, and 3 to foot and finger arterial
segment. Related to the antithrombotic therapy, 3 EVE were from
the ASA group, 1 EVE were from the clopidogrel + ASA group, and
1 from the clopidogrel group. An overall outcome was 1 above-knee
amputation. An above-knee amputation followed EVE of iliaco-femoral
segment (patient with already iliaco-femoral stenosis). All foot
and finger EVE were solved out without amputations. Conclusions:
we followed a high risk group of pts, all with type C of aortic
aneurysms, an average lumen diameter was 5,9 cm, with thrombotic
and ulcerous inner arterial wall. Occurence of EVE was of low
correlation rank, r=.36. We had 5 EVE, and out of them 1 amputation.
There was no significancy in occurence of EVE related to type
of antithrombotic therapy, p=0,02, NS.