Howell M H, Zaqqa M, Villareal R P, Strickman N E, Krajcer Z
The Department of Cardiology, Texas Heart Institute at St. Luke's Episcopal Hospital, Houston, USA.
Tex Heart Inst J. 2000;27(2):136-45.
The use of an endovascular stent-graft prosthesis for the treatment of infrarenal abdominal aortic aneurysms is receiving increasing attention as an option that may avoid the significant morbidity and mortality associated with open surgical treatment. We studied the clinical effectiveness of stent-grafts in patients with infrarenal abdominal aortic aneurysms. Between October 1995 and May 1998, 33 patients underwent infrarenal abdominal aortic aneurysm exclusion with a homemade polytetrafluoroethylene-covered stent, and between November 1998 and September 1999, 56 patients underwent abdominal aortic aneurysm exclusion with the Medtronic AneuRx stent-graft. Overall, these patients represented a high-risk surgical group. The technical success rate was 100% in both groups. No patient required immediate conversion to open repair. With the polytetrafluoroethylene-covered stent, the primary success rate was 33%, and the secondary success rate was 76%. In the AneuRx group, the primary success rate was 82.8%, and the secondary success rate was 85.3% at 6 months. There was no procedural or 1-month mortality or major morbidity in either group. By showing that infrarenal abdominal aortic aneurysms can be treated safely and successfully with an endoluminal stent-graft, our early results provide additional support for the endovascular treatment of abdominal aortic aneurysms. Further follow-up studies will determine the long-term ability of such treatment to prevent aneurysmal rupture and death.
作为一种可避免与开放性手术治疗相关的显著发病率和死亡率的选择，使用血管内支架移植物假体治疗肾下腹主动脉瘤正受到越来越多的关注。我们研究了支架移植物在肾下腹主动脉瘤患者中的临床疗效。1995年10月至1998年5月，33例患者采用自制的聚四氟乙烯覆盖支架进行了肾下腹主动脉瘤切除术；1998年11月至1999年9月，56例患者采用美敦力AneuRx支架移植物进行了腹主动脉瘤切除术。总体而言，这些患者代表了一个高风险手术组。两组的技术成功率均为100%。没有患者需要立即转为开放性修复。使用聚四氟乙烯覆盖支架时，初次成功率为33%，二次成功率为76%。在AneuRx组中，6个月时的初次成功率为82.8%，二次成功率为85.3%。两组均无手术或1个月死亡率或重大并发症。通过表明肾下腹主动脉瘤可以通过腔内支架移植物安全、成功地治疗，我们的早期结果为腹主动脉瘤的血管内治疗提供了额外的支持。进一步的随访研究将确定这种治疗预防动脉瘤破裂和死亡的长期能力。
