England Andrew, Butterfield John S, McCollum Charles N, Ashleigh Raymond J
Department of Medical Imaging & Radiotherapy, University of Liverpool, Johnston Building, Quadrangle, Brownlow Hill, Liverpool, L69 3GB, UK.
Cardiovasc Intervent Radiol. 2008 Jul-Aug;31(4):723-7. doi: 10.1007/s00270-008-9318-4. Epub 2008 Mar 14.
The purpose of this study is to report outcomes following endovascular aneurysm repair (EVAR) of abdominal aortic aneurysm (AAA) in patients with ectatic common iliac arteries (CIAs). Of 117 AAA patients treated by EVAR between 1998 and 2005, 87 (74%) had CIAs diameters <18 mm and 30 (26%) patients had one or more CIA diameters >18 but <25 mm. All patients were treated with Talent stent-grafts, 114 bifurcated and 3 AUI devices. Departmental databases and patient records were reviewed to assess outcomes. Technical success, iliac-related outcome, and iliac-related reintervention (IRSI) were analyzed. Patients with EVAR extending into the external iliac artery were excluded. Median (range) follow-up for the study group was 24 (1-84) months. Initial technical success was 98% for CIAs <18 mm and 100% for CIAs >/=18 mm (p = 0.551). There were three distal type I endoleaks (two in the ectatic group) and six iliac limb occlusions (one in an ectatic patient); there were no statistically significant differences between groups (p = 0.4). There were nine IRSIs (three stent-graft extensions, six femorofemoral crossover grafts); three of these patients had one or both CIAs >/=18 mm (p = 0.232). One-year freedom from IRSI was 92% +/- 3% and 84% +/- 9% for the <18-mm and >/=18-mm CIA groups, respectively (p = 0.232). We conclude that the treatment of AAA by EVAR in patients with CIAs 18-24 mm appears to be safe and effective, however, it may be associated with more frequent reinterventions.
本研究的目的是报告患有扩张性髂总动脉（CIA）的腹主动脉瘤（AAA）患者接受腹主动脉瘤腔内修复术（EVAR）后的结果。在1998年至2005年间接受EVAR治疗的117例AAA患者中，87例（74%）的CIA直径<18 mm，30例（26%）患者的一个或多个CIA直径>18但<25 mm。所有患者均采用Talent覆膜支架治疗，其中114例为分叉型，3例为AUI装置。回顾部门数据库和患者记录以评估结果。分析技术成功率、髂动脉相关结果和髂动脉相关再次干预（IRSI）。排除EVAR延伸至髂外动脉的患者。研究组的中位（范围）随访时间为24（1 - 84）个月。CIA<18 mm组的初始技术成功率为98%，CIA≥18 mm组为100%（p = 0.551）。有3例远端I型内漏（扩张组2例）和6例髂支闭塞（扩张患者1例）；两组之间无统计学显著差异（p = 0.4）。有9例IRSI（3例支架移植物延伸，6例股股交叉移植）；其中3例患者的一个或两个CIA≥18 mm（p = 0.232）。CIA<18 mm组和CIA≥18 mm组的1年无IRSI率分别为92%±3%和84%±9%（p = 0.232）。我们得出结论，对于CIA为18 - 24 mm的患者，通过EVAR治疗AAA似乎是安全有效的，然而，它可能与更频繁的再次干预相关。
