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Second Congress of Cardiology and Angiology of Bosnia & Herzegovina


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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