Division of Vascular and Endovascular, Surgery, Saint Michael's Hospital, University of Toronto, Ontario, Canada.
J Vasc Surg. 2010 Apr;51(4):1056-60. doi: 10.1016/j.jvs.2009.09.008. Epub 2010 Jan 4.
Endovascular repair is an established modality of treatment for abdominal aortic aneurysms. It is therefore reasonable to expect its application to other less common aneurysmal conditions, including isolated iliac and popliteal artery aneurysms (PAA). There are, however, essential differences between aortic aneurysms and peripheral aneurysms: smaller arterial caliber, mobility of the arterial segment, associated occlusive disease, and devices that have not been specifically designed for peripheral applications. Due to these differences, results obtained in abdominal aortic aneurysms cannot be extrapolated to peripheral aneurysms. The attraction of the endovascular repair for PAA is its minimally invasive nature. The literature, however, provides only case reports, case series and small cohorts, and one small randomized, controlled trial. A cumulative summary of these studies provides the clinician with information upon which to base the choice of treatment on a specific patient. Endovascular repair for PAA with suitable anatomy and good run-off can be considered safe, and medium term results appear comparable with those of open repair.
血管内修复术是治疗腹主动脉瘤的一种成熟治疗方式。因此,可以合理地期望将其应用于其他不太常见的动脉瘤情况,包括孤立的髂动脉和腘动脉动脉瘤(PAA)。然而,主动脉瘤和外周动脉瘤之间存在本质区别:较小的动脉口径、动脉节段的活动性、相关的闭塞性疾病以及尚未专门为外周应用设计的器械。由于这些差异,在腹主动脉瘤中获得的结果不能外推到外周动脉瘤。血管内修复术对 PAA 的吸引力在于其微创性。然而,文献仅提供了病例报告、病例系列和小队列研究,以及一项小型随机对照试验。对这些研究的累积总结为临床医生提供了信息,以便根据具体患者选择治疗方案。对于具有合适解剖结构和良好流出道的 PAA 进行血管内修复可以被认为是安全的,并且中期结果似乎与开放修复相当。