Hausegger K A, Mendel H, Tiessenhausen K, Kaucky M, Aman W, Tauss J, Koch G
Department of Radiology, University of Graz, Austria.
J Vasc Interv Radiol. 1999 Mar;10(3):267-74. doi: 10.1016/s1051-0443(99)70029-1.
To evaluate the safety and efficacy of the Talent stent-graft (TSG) system in the endoluminal treatment of infrarenal abdominal aortic aneurysms (AAAs).
Endoluminal treatment of an AAA was attempted in 30 men with a mean age of 70.5 years (range, 51-83 years). Seven patients had AAAs suitable for treatment with a tube graft. In the other patients, treatment with a bifurcated TSG was planned. All procedures were performed as a combined surgical-radiologic procedure in an angiographic room.
Primary technical success was achieved in 25 of 30 patients (83%). Technical failures were due to misplacement of the TSG (n = 2) with proximal leakage as a consequence, inability to gain access via the iliac arteries (n = 1), and a distal leakage (n = 2). Secondary interventions (n = 2) and spontaneous thrombosis of a distal leak (n = 1) increased the secondary technical success rate to 93% (28 of 30). Two procedures were converted to open surgery (conversion rate = 6%). One patient died during the first 30 days after uncomplicated stent-graft insertion because of myocardial infarction (30-day mortality = 5%). No complications occurred during a mean follow-up of 15.4 months (range, 6-19 months). The maximum diameter of the AAA decreased in eight patients and remained unchanged in the remaining patients. No increase in diameter was observed. No late endoleak or migration of the TSG was observed.
The TSG-system revealed satisfactory initial and early follow-up results. Treatment of AAAs with this stent-graft system is feasible. The technical success rate in carefully selected patients should be 90% or more. However, long-term observations are necessary to determine if the encouraging early results of this type of therapy can be preserved during long-term follow-up.
评估Talent覆膜支架系统（TSG）用于肾下腹主动脉瘤（AAA）腔内治疗的安全性和有效性。
对30名平均年龄70.5岁（范围51 - 83岁）的男性患者尝试进行AAA腔内治疗。7名患者的AAA适合使用直管型移植物治疗。其他患者计划使用分叉型TSG进行治疗。所有手术均在血管造影室作为外科 - 放射联合手术进行。
30例患者中有25例（83%）获得了初次技术成功。技术失败的原因包括TSG放置不当（n = 2）导致近端渗漏、无法经髂动脉进入（n = 1）以及远端渗漏（n = 2）。二次干预（n = 2）和远端渗漏的自发血栓形成（n = 1）使二次技术成功率提高到93%（30例中的28例）。2例手术转为开放手术（转换率 = 6%）。1例患者在无并发症的覆膜支架置入术后30天内死于心肌梗死（30天死亡率 = 5%）。在平均15.4个月（范围6 - 19个月）的随访期间未发生并发症。8例患者的AAA最大直径减小，其余患者保持不变。未观察到直径增大。未观察到TSG的晚期内漏或移位。
TSG系统显示出令人满意的初始和早期随访结果。使用该覆膜支架系统治疗AAA是可行的。在精心挑选的患者中技术成功率应达到90%或更高。然而，需要长期观察以确定这种治疗方式令人鼓舞的早期结果在长期随访中是否能够维持。
