Department of Radiology and Research Institute of Radiological Science, Severance Hospital, University of Yonsei, College of Medicine, Seoul 120-752, Korea.
Korean J Radiol. 2010 Jan-Feb;11(1):107-14. doi: 10.3348/kjr.2010.11.1.107. Epub 2009 Dec 28.
The purpose of this study was to evaluate the technical feasibility and clinical efficacy of percutaneous transabdominal treatment of endoleaks after endovascular aneurysm repair.
Between 2000 and 2007, six patients with type I (n = 4) or II (n = 2) endoleaks were treated by the percutaneous transabdominal approach using embolization with N-butyl cyanoacrylate with or without coils. Five patients underwent a single session and one patient had two sessions of embolization. The median time between aneurysm repair and endoleak treatment was 25.5 months (range: 0-84 months). Follow-up CT images were evaluated for changes in the size and shape of the aneurysm sac and presence or resolution of endoleaks. The median follow-up after endoleak treatment was 16.4 months (range: 0-37 months)
Technical success was achieved in all six patients. Clinical success was achieved in four patients with complete resolution of the endoleak confirmed by follow-up CT. Clinical failure was observed in two patients. One eventually underwent surgical conversion, and the other was lost to follow-up. There were no procedure-related complications.
The percutaneous transabdominal approach for the treatment of type I or II endoleaks, after endovascular aneurysm repair, is an alternative method when conventional endovascular methods have failed.
本研究旨在评估经腹穿刺治疗血管内动脉瘤修复术后内漏的技术可行性和临床疗效。
2000 年至 2007 年间，6 例 I 型（n=4）或 II 型（n=2）内漏患者采用经腹穿刺途径，使用 N-丁基氰基丙烯酸酯联合或不联合线圈进行栓塞治疗。5 例患者接受单次栓塞，1 例患者接受 2 次栓塞。动脉瘤修复与内漏治疗之间的中位时间为 25.5 个月（范围：0-84 个月）。通过 CT 随访评估瘤囊大小和形状的变化以及内漏的存在或消失。内漏治疗后中位随访时间为 16.4 个月（范围：0-37 个月）。
6 例患者均获得技术成功。4 例患者临床成功，内漏完全消失，经 CT 随访证实。2 例患者临床失败。其中 1 例最终改行手术治疗，1 例失访。无与手术相关的并发症。
对于血管内动脉瘤修复术后的 I 型或 II 型内漏，经腹穿刺治疗是传统血管内方法失败时的一种替代方法。
