Department of Surgery, New York Presbyterian Hospital, Columbia University Medical Center, 630 West 168th Street, New York, NY 10032, USA.
World J Surg. 2010 Dec;34(12):2969-72. doi: 10.1007/s00268-010-0789-5.
The differences in implantable pressure sensor aneurysm sac readings were compared following endovascular aneurysm repair (EVAR) among three different stent grafts.
From January 2006 to March 2009, 51 aortic stent grafts were implanted along with the Endosure sensor. Grafts used were Zenith, Talent, and Excluder. In the present retrospective study, pulse ratios were measured intraoperatively before and after aneurysm sac exclusion and in follow-up (within 30 days). Analysis of variance was used to determine significance.
The average aneurysm size that was repaired was 5.75 cm (range: 4-8.5 cm); 41 patients (80.4%) being male with an average age of 76.3 years (range: 58-90 years). Thirty-four grafts were Zenith, 9 were Talent, and 8 were Excluder. The average pre-aneurysm exclusion pulse ratios for the Zenith, Talent, and Excluder were 1.00, 1.08, and 0.95 (p = 0.18), respectively. The average post-aneurysm exclusion pulse ratios were 0.34, 0.67, and 0.35, respectively (p = 0.003). Pulse ratios at the time of follow-up (within 30 days) were 0.17, 0.22, and 0.11, respectively (p = 0.44). Nine of 51 (17.6%) patients had a reduction of pulse ratio of less than 30% after endograft implantation. Five of those 9 patients (55.5%) had the Talent endograft, although there was no angiographic evidence of endoleak.
The Talent graft has significantly higher pulse ratios following endograft implantation despite having no angiographic evidence of endoleak when compared to the Zenith and Excluder grafts. However, the pulse ratios decreased to levels similar to Zenith and Excluder within 30 days of endograft implantation. This suggests that the Talent endograft may have increased porosity initially. If pulse ratios do not appropriately decrease immediately after device implantation, further angiographic imaging may not be necessary if no obvious endoleak is seen.
比较了三种不同支架移植物血管内动脉瘤修复（EVAR）后植入式压力传感器动脉瘤囊读数的差异。
2006 年 1 月至 2009 年 3 月，51 例主动脉支架移植物与 Endosure 传感器一起植入。使用的移植物为 Zenith、Talent 和 Excluder。在本回顾性研究中，术中在动脉瘤囊排除前后和随访时（30 天内）测量脉冲比。采用方差分析确定显著性。
平均修复的动脉瘤大小为 5.75cm（范围：4-8.5cm）；41 例患者（80.4%）为男性，平均年龄为 76.3 岁（范围：58-90 岁）。34 例移植物为 Zenith，9 例为 Talent，8 例为 Excluder。Zenith、Talent 和 Excluder 的平均术前排除动脉瘤的脉冲比分别为 1.00、1.08 和 0.95（p=0.18）。平均术后排除动脉瘤的脉冲比分别为 0.34、0.67 和 0.35（p=0.003）。随访时（30 天内）的脉冲比分别为 0.17、0.22 和 0.11（p=0.44）。51 例患者中有 9 例（17.6%）患者在植入内支架后脉冲比降低小于 30%。其中 5 例（55.5%）患者使用 Talent 移植物，尽管没有血管内漏的血管造影证据。
与 Zenith 和 Excluder 移植物相比，尽管没有血管内漏的血管造影证据，但 Talent 移植物在植入内支架后脉冲比显著升高。然而，在植入内支架后 30 天内，脉冲比降至与 Zenith 和 Excluder 相似的水平。这表明 Talent 移植物最初可能具有更高的孔隙率。如果设备植入后脉冲比没有适当降低，如果没有明显的血管内漏，进一步的血管造影成像可能不是必要的。
