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髂动脉瘤的血管内治疗

The endovascular management of iliac artery aneurysms.

作者信息

Stroumpouli Evangelia, Nassef Ahmed, Loosemore Tom, Thompson Matt, Morgan Robert, Belli Anna-Maria

机构信息

Department of Radiology, St George's Hospital, Blackshaw Road, London SW17 0QT, UK.

出版信息

Cardiovasc Intervent Radiol. 2007 Nov-Dec;30(6):1099-104. doi: 10.1007/s00270-007-9133-3. Epub 2007 Aug 9.

Abstract

BACKGROUND

Isolated aneurysms of the iliac arteries are uncommon. Previously treated by conventional surgery, there is increasing use of endografts to treat these lesions.

PURPOSE

The purpose of this study was to assess the efficacy, safety, and durability of the stent-grafts for treatment of iliac artery aneurysms (IAAs). The results of endografting for isolated IAAs over a 10-year period were analyzed retrospectively. The treatment methods differed depending on the anatomic location of the aneurysms. Twenty-one patients (1 woman, 20 men) underwent endovascular stent-graft repair, with one procedure carried out under emergency conditions after acute rupture. The mean aneurysm diameter was 4.6 cm.

RESULTS

The procedural technical success was 100%. There was zero 30-day mortality. Follow-up was by interval CT scans. At a mean follow-up of 51.2 months, the stent-graft patency rate was 100%. Reintervention was performed in four patients (19%): one patient (4.7%) with a type I endoleak and three patients (14.3%) with type II endoleaks.

CONCLUSION

We conclude that endovascular repair of isolated IAAs is a safe, minimally invasive technique with low morbidity rates. Follow-up results up to 10 years suggest that this approach is durable and should be regarded as a first treatment option for appropriate candidates.

摘要

背景

孤立性髂动脉瘤并不常见。以往通过传统手术治疗,现在越来越多地使用腔内移植物来治疗这些病变。

目的

本研究的目的是评估支架型人工血管治疗髂动脉瘤(IAA)的疗效、安全性和耐久性。回顾性分析10年间孤立性IAA腔内修复的结果。治疗方法根据动脉瘤的解剖位置而有所不同。21例患者(1例女性,20例男性)接受了血管内支架型人工血管修复术,其中1例在急性破裂后急诊手术。动脉瘤平均直径为4.6cm。

结果

手术技术成功率为100%。30天死亡率为零。通过定期CT扫描进行随访。平均随访51.2个月时,支架型人工血管通畅率为100%。4例患者(19%)进行了再次干预:1例患者(4.7%)发生I型内漏,3例患者(14.3%)发生II型内漏。

结论

我们得出结论,孤立性IAA的血管内修复是一种安全、微创的技术,发病率低。长达10年的随访结果表明,这种方法具有耐久性,应被视为合适患者的首选治疗方案。

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