Sandford R M, Bown M J, Sayers R D, Fishwick G, London N J, Nasim A
Vascular Surgery Group, Department of Cardiovascular Sciences, University of Leicester, Leicester Royal Infirmary, Leicester, UK.
Ann Vasc Surg. 2008 May-Jun;22(3):372-8. doi: 10.1016/j.avsg.2007.09.017.
Endovascular aneurysm repair (EVAR) offers a minimally invasive alternative to open repair and has the benefits of reduced perioperative morbidity and mortality. There are potential complications specific to EVAR, including device failure, graft migration, and endoleak, which necessitate long-term follow-up. This remains a relatively novel technique, and therefore, little long-term data exist. This study reports 5-year EVAR outcome data from a single center. Five-year follow-up data for 58 patients at a single center who underwent EVAR using a variety of different commercial devices was reviewed. All patients were followed up with 6-monthly duplex ultrasound scanning and clinical assessment in a nurse-led clinic, in addition to yearly computed tomographic (CT) scans for those participating in the EVAR trial. All patients in this series were male, with a median age of 72 years (range 58-81). Mean preoperative aortic diameter was 5.95 cm, and this reduced following EVAR to 5.2 cm (mean diameter) at 5 years. Mean hospital stay was 7 days, and there were no perioperative deaths. There were 20 (34%) early and 15 (26%) late complications. There were 13 endoleaks confirmed on CT; four (31%) were type I and nine (69%) were type II. All-cause mortality was 26%. There were no late aneurysm-related deaths. EVAR has the advantages of shorter hospital stay and reduced perioperative morbidity and mortality. Long-term follow-up remains a priority following aortic stenting in order to detect late complications such as endoleak.
血管内动脉瘤修复术(EVAR)为开放性修复提供了一种微创替代方案,具有降低围手术期发病率和死亡率的优点。EVAR有一些特定的潜在并发症,包括器械故障、移植物移位和内漏,这就需要长期随访。这仍然是一项相对新颖的技术,因此,长期数据很少。本研究报告了来自单一中心的5年EVAR结果数据。回顾了单一中心58例使用各种不同商用器械接受EVAR的患者的5年随访数据。除了对参与EVAR试验的患者进行年度计算机断层扫描(CT)外,所有患者均在护士主导的诊所接受每6个月一次的双功超声扫描和临床评估。本系列所有患者均为男性,中位年龄72岁(范围58 - 81岁)。术前主动脉平均直径为5.95 cm,EVAR后5年降至5.2 cm(平均直径)。平均住院时间为7天,无围手术期死亡。有20例(34%)早期并发症和15例(26%)晚期并发症。CT证实有13例内漏;4例(31%)为I型,9例(69%)为II型。全因死亡率为26%。无晚期动脉瘤相关死亡。EVAR具有住院时间短、围手术期发病率和死亡率降低的优点。主动脉支架置入术后,长期随访仍然是检测内漏等晚期并发症的首要任务。