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Second Congress of Cardiology and Angiology of Bosnia & Herzegovina

 

LONG TERM PREVENTION OF VASCULAR EVENTS DUE TO AORTIC ANEURYSMS
M. Dilić, S. Pehar, S.Kazić, O.Terzić and U.Šalaka.
Institute of Vascular Diseases, Clinical Center University of Sarajevo, Bosnalijek, Sarajevo, Bosnia and Herzegovina

Background: 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.

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