May J, White G H, Waugh R, Stephen M S, Chaufourt X, Yut W, Harris J P
Department of Surgery, University of Sydney, New South Wales, Australia.
Cardiovasc Surg. 1999 Aug;7(5):484-90. doi: 10.1016/s0967-2109(99)00028-9.
The purpose of this paper is to briefly review the historical aspects and outcome of endoluminal abdominal aortic aneurysm (AAA) repair and summarise two studies presented at the 1997 and 1998 meetings of the Society for Vascular Surgery.
Between May 1992 and September 1998 the endoluminal method was used to repair arterial aneurysms in 304 patients at the Royal Prince Alfred Hospital, Sydney, a tertiary referral teaching hospital. The study focuses on 243 patients with true AAA who underwent primary repair. There were 17 females and 226 males with a mean age of 72 years. Co-morbidities leading to rejection for conventional open repair were present in 83 patients. The criteria for inclusion included a segment of thrombus-free aorta between the lowermost renal artery and the commencement of the aneurysm of 1.5 cm or greater and iliac arteries that allowed access to the aorta from the groin. The technique involved the delivery of an endograft into the abdominal aorta by means of a sheath inserted through the femoral or iliac artery. Laparotomy associated with conventional open repair was avoided. Outcome measures included clinical examination and contrast-enhanced computed tomography (CT) within 10 days, at 6, 12, 18 months after operation and then annually thereafter.
Endografts were successfully deployed in 226 patients. In the remaining 17 patients endoluminal repair was converted to open repair. There were 8 deaths within 30 days of operation giving a perioperative mortality rate of 3.3%. The two studies presented to the Society for Vascular Surgery concern: (i) a concurrent comparison of the endoluminal versus open methods of treating AAA; and (ii) a comparison of adverse events following endoluminal repair of AAA during two consecutive periods of time.
本文旨在简要回顾腔内腹主动脉瘤（AAA）修复术的历史背景和治疗结果，并总结在1997年和1998年血管外科学会会议上发表的两项研究。
1992年5月至1998年9月期间，悉尼的皇家阿尔弗雷德王子医院（一家三级转诊教学医院）采用腔内方法为304例患者修复动脉动脉瘤。该研究聚焦于243例接受初次修复的真性AAA患者。其中女性17例，男性226例，平均年龄72岁。83例患者因合并症而无法接受传统的开放修复。纳入标准包括：肾动脉最低点与动脉瘤起始处之间无血栓的主动脉段长度≥1.5 cm，且髂动脉条件允许通过腹股沟进入主动脉。该技术是通过经股动脉或髂动脉插入的鞘管将腔内移植物输送至腹主动脉。避免了与传统开放修复相关的剖腹手术。观察指标包括术后10天内、术后6、12、18个月以及此后每年进行的临床检查和增强计算机断层扫描（CT）。
226例患者成功植入腔内移植物。其余17例患者的腔内修复转为开放修复。术后30天内有8例死亡，围手术期死亡率为3.3%。提交给血管外科学会的两项研究分别涉及：（i）腔内治疗与开放治疗AAA方法的同期比较；（ii）连续两个时间段内AAA腔内修复术后不良事件的比较。
