Wolf Florian, Loewe Christian, Cejna Manfred, Schoder Maria, Rand Thomas, Kettenbach Joachim, Dirisamer Albert, Lammer Johannes, Funovics Martin
Medical University of Vienna, Clinical Department of Cardiovascular and Interventional Radiology, Waehringer Guertel 18-20, A-1090 Vienna, Austria.
Eur J Radiol. 2008 Mar;65(3):491-7. doi: 10.1016/j.ejrad.2007.04.004. Epub 2007 May 22.
To report about the endovascular treatment of isolated iliac artery aneurysms (IIAA) with stentgraft placement and transluminal or CT-guided embolization of the internal iliac artery or the combination of these methods.
Over a period of 5.6 years, 36 interventions were performed in 20 patients with 23 IIAAs. In a retrospective analysis patient records were reviewed. The CT-angiography follow-up was evaluated for the presence of re-perfusion of the IIAA and for change of aneurysm diameter.
Primary success was achieved in 15/23 aneurysms (65%), and secondary success in 21/23 aneurysms (91%). In 5/23 cases two interventions and in 1/23 cases three interventions were necessary to achieve secondary success. Embolization alone, as a therapy for aneurysms involving only the internal iliac artery, had a success rate of 27%. No procedure-related minor or major complications occurred. Mean decrease of aneurysm size during a mean observation period of 14.1 months was 6.9% which was not significant (p=0.3; 95% confidence interval +7-21%).
Endovascular therapy of isolated iliac artery aneurysms performed percutaneously has become a treatment alternative to open surgical repair. This method is feasible and safe with low procedure-related morbidity and mortality. However, on average more than one intervention has to be performed to achieve successful permanent exclusion of the aneurysm and embolization alone in isolated internal iliac artery aneurysms is not sufficient.
报告采用支架移植物置入术、经腔或CT引导下对髂内动脉进行栓塞术或联合使用这些方法对孤立性髂动脉瘤（IIAA）进行血管内治疗的情况。
在5.6年的时间里，对20例患者的23个IIAA进行了36次干预。通过回顾性分析对患者记录进行了审查。对CT血管造影随访结果进行评估，以确定IIAA是否存在再灌注以及动脉瘤直径的变化。
15/23个动脉瘤（65%）取得了初次成功，21/23个动脉瘤（91%）取得了二次成功。在5/23例中需要进行两次干预，在1/23例中需要进行三次干预才能取得二次成功。仅作为累及髂内动脉的动脉瘤的治疗方法，单纯栓塞术的成功率为27%。未发生与手术相关的轻微或严重并发症。在平均14.1个月的观察期内，动脉瘤大小的平均减小率为6.9%，差异无统计学意义（p = 0.3；95%置信区间为+7-21%）。
经皮进行的孤立性髂动脉瘤血管内治疗已成为开放性手术修复的替代治疗方法。该方法可行且安全，与手术相关的发病率和死亡率较低。然而，平均需要进行不止一次干预才能成功永久性排除动脉瘤，对于孤立性髂内动脉瘤，单纯栓塞术是不够的。
