[肾下腹主动脉瘤腔内修复术后常见并发症的预防与处理]

[Prevention and management of frequent complications after endovascular repair of infrarenal abdominal aortic aneurysm].

作者信息

Kong Qing-long, Guo Wei, Liu Xiao-ping, Zhang Guo-hua, Liang Fa-qi, Li Rong

机构信息

Department of General Surgery, General Hospital of People's Liberation Army, Beijing 100853, China.

出版信息

Zhonghua Wai Ke Za Zhi. 2003 Jul;41(7):495-8.

PMID:12921652

Abstract

OBJECTIVE

To prevent and manage frequent complications after endovascular repair of infrarenal abdominal aortic aneurysm (AAA).

METHODS

The data of 71 cases of infrarenal abdominal aortic aneurysm (AAA) treated by endovascular repair were analysed retrospectively. The reasons, managements, results and prognosis of frequent complications were investigated.

RESULTS

Seventy-one cases of infrarenal AAA were treated by endovascular repair with 100% success rate. There was no surgical conversion to open aneurysm repair. There were 8 cases of primary endoleak, 1 case of nervous complication and acute thrombosis. An average follow-up period was 26 +/- 5 months. Three persistent endoleaks and 4 secondary endoleaks were found during the follow-up period. The endoleak rate was 9.8% (7/71) within 1 month postoperatively and mortality rate was 1.3% (1/71). Total mortality rate was 4.2% (3/71). Two patients died from acute myocardial infarction and one from acute heart failure.

CONCLUSIONS

Endovascular treatment of abdominal aortic aneurysm is technically feasible and can effectively exclude aortic aneurysms from the circulation. Endoleak is a chief complication after endovascular repair of infrarenal AAA.Additional procedures and follow up are very important. Endoleak with enlarged aneurysm should be treated actively.

摘要

目的

预防和处理肾下腹主动脉瘤（AAA）腔内修复术后常见并发症。

方法

回顾性分析71例接受腔内修复治疗的肾下腹主动脉瘤（AAA）患者的数据。调查常见并发症的原因、处理方法、结果及预后。

结果

71例肾下腹主动脉瘤患者接受腔内修复，成功率达100%。无手术转为开放动脉瘤修复的情况。发生原发性内漏8例，神经并发症及急性血栓形成各1例。平均随访时间为26±5个月。随访期间发现3例持续性内漏和4例继发性内漏。术后1个月内漏发生率为9.8%（7/71），死亡率为1.3%（1/71）。总死亡率为4.2%（3/71）。2例患者死于急性心肌梗死，1例死于急性心力衰竭。