Springer Fabian, Günther Rolf W, Schmitz-Rode Thomas
Applied Medical Engineering, Helmholtz Institute for Biomedical Engineering, RWTH Aachen University, Pauwelsstrasse 20, 52074 Aachen, Germany.
Cardiovasc Intervent Radiol. 2008 May-Jun;31(3):460-7. doi: 10.1007/s00270-007-9245-9. Epub 2007 Dec 18.
Current protocols for surveillance after endovascular repair (EVAR) of abdominal aortic aneurysms are mostly based on costly and time-consuming imaging procedures and aim to detect adverse events such as graft migration, endoleaks or aneurysm sac enlargement. These imaging procedures are either associated with radiation exposure to the patients or may be harmful to the patient due to the use of iodine- or gadolinium-containing contrast agents. Furthermore the advantages of EVAR in the short term might be negated by the necessity for endograft surveillance over years. Thus, alternative modalities for follow-up are being investigated. One of these technologies provides pressure information directly from the aneurysm sac. This noninvasive, telemetric pressure sensing was tested in vitro as well as in first clinical trials and was able to identify successful aneurysm exclusion after EVAR. The telemetric pressure sensors showed a promising efficacy and accuracy in detecting type I and type III endoleaks and will help to clarify the clinical relevance of type II endoleaks. This article provides an overview of the in vitro sensors investigated as well as the first clinical trials and the sensors' potential to change the current endograft surveillance regimes.
目前腹主动脉瘤血管内修复术（EVAR）后的监测方案大多基于昂贵且耗时的成像程序，旨在检测诸如移植物移位、内漏或动脉瘤囊扩大等不良事件。这些成像程序要么会使患者受到辐射暴露，要么因使用含碘或含钆造影剂而可能对患者有害。此外，多年来对血管内移植物进行监测的必要性可能会抵消EVAR在短期内的优势。因此，正在研究替代的随访方式。其中一项技术可直接从动脉瘤囊中获取压力信息。这种非侵入性的遥测压力传感已在体外以及首次临床试验中进行了测试，并且能够识别EVAR术后成功的动脉瘤排除情况。遥测压力传感器在检测I型和III型内漏方面显示出有前景的疗效和准确性，并将有助于阐明II型内漏的临床相关性。本文概述了所研究的体外传感器以及首次临床试验情况，以及这些传感器改变当前血管内移植物监测方案的潜力。
