Department of Vascular Surgery, The University of Tokyo Hospital, Tokyo, Japan.
Eur J Vasc Endovasc Surg. 2010 Nov;40(5):559-63. doi: 10.1016/j.ejvs.2010.07.018. Epub 2010 Aug 23.
To verify the usefulness and limitation of intravascular ultrasound (IVUS) in endovascular aneurysm repair (EVAR).
A total of 112 consecutive patients, who underwent EVAR to treat abdominal aortic aneurysms, were examined retrospectively. Of these, 33 patients were assigned to the IVUS group because of renal failure, a suspected allergy to contrast agents or anatomical difficulties; the remaining 79 patients were assigned to the non-IVUS group.
Patients in the IVUS group required fewer intra-arterial contrast agents (IACAs) than those in the non-IVUS group (67±34ml vs. 123±50ml; p<0.01). Blood loss and operation time were comparable between the two groups. No patients died within 30 days of the operation. Three major renal complications occurred in the non-IVUS group. Renal deterioration evaluated by chronic kidney disease (CKD) stage was found to a greater extent in the non-IVUS group.
IVUS is a powerful auxiliary method in EVAR for reducing the required volume of contrast agents. The combination of IVUS and IACA usage showed good overall performance; thus, we propose the routine use of IVUS in EVAR procedures.
验证血管内超声（IVUS）在血管内动脉瘤修复（EVAR）中的作用和局限性。
回顾性分析 112 例接受 EVAR 治疗腹主动脉瘤的连续患者。其中 33 例因肾功能衰竭、疑似对比剂过敏或解剖困难而被分配到 IVUS 组；其余 79 例患者被分配到非-IVUS 组。
IVUS 组患者所需的动脉内对比剂（IACA）少于非-IVUS 组（67±34ml vs. 123±50ml；p<0.01）。两组间的出血量和手术时间相当。术后 30 天内无患者死亡。非-IVUS 组发生 3 例严重肾功能并发症。非-IVUS 组的慢性肾脏病（CKD）分期评估的肾功能恶化程度更大。
IVUS 是 EVAR 中减少对比剂用量的有力辅助方法。IVUS 与 IACA 使用相结合表现出良好的整体性能；因此，我们建议在 EVAR 手术中常规使用 IVUS。
