Pilon Fabio, Tosato Federico, Danieli Dario, Campanile Francesco, Zaramella Massimiliano, Milite Domenico
Operative Unit of Vascular and Endovascular Surgery, San Bortolo Hospital, Vicenza, Italy.
Interact Cardiovasc Thorac Surg. 2010 Jul;11(1):78-82. doi: 10.1510/icvts.2009.231167. Epub 2010 Apr 8.
To verify in our experience if fibrin glue injection into the aneurysm sac, made at the end of endovascular aneurysm repair (EVAR), can reduce type II endoleak rates.
Between January 2005 and February 2008, 38 patients underwent EVAR for an unruptured abdominal aortic aneurysm. The first 20 consecutive patients (Group A) had standard EVAR while the last 18 patients (Group B) had EVAR with fibrin glue injection into the sac, regardless of type II endoleak's presence.
There was no statistically significant difference between the two groups concerning the surgical time and the time of X-ray exposure (P=0.30 and 0.54, respectively). Type II endoleak rate was significantly higher in Group A compared to Group B (6 cases, 30% vs. 1 case, 5.5%, respectively, P=0.05). Primary short-term clinical success was 95% and 100%, respectively. At 12 months, selective lumbar embolization was performed in two patients in Group A and in one patient in Group B. Patients in Group A had less computed tomography (CT) studies than patients in Group B (2.0 vs. 1.2, respectively, P=0.024).
Fibrin glue injection is a safe procedure and seems to reduce type II endoleak rates. Patients who received this procedure had fewer CT examinations, with reduced health-care costs.
根据我们的经验，验证在血管内动脉瘤修复术（EVAR）结束时向动脉瘤腔内注射纤维蛋白胶是否能降低Ⅱ型内漏发生率。
2005年1月至2008年2月，38例患者因未破裂腹主动脉瘤接受了EVAR治疗。前20例连续患者（A组）接受标准EVAR，而后18例患者（B组）无论是否存在Ⅱ型内漏，均在EVAR时向瘤腔内注射纤维蛋白胶。
两组在手术时间和X线暴露时间方面无统计学显著差异（分别为P = 0.30和0.54）。A组的Ⅱ型内漏发生率显著高于B组（分别为6例，30% 对1例，5.5%，P = 0.05）。短期主要临床成功率分别为95%和100%。在12个月时，A组有2例患者和B组有1例患者接受了选择性腰动脉栓塞。A组患者的计算机断层扫描（CT）检查次数少于B组（分别为2.0次对1.2次，P = 0.024）。
注射纤维蛋白胶是一种安全的操作，似乎能降低Ⅱ型内漏发生率。接受该操作的患者CT检查次数较少，医疗费用降低。
