Department of Vascular Surgery, University Hospital Gasthuisberg, Leuven, Belgium.
J Vasc Surg. 2011 Jul;54(1):48-57.e2. doi: 10.1016/j.jvs.2010.12.068. Epub 2011 Apr 2.
This study assessed the long-term outcome of patients with abdominal aortic and aortoiliac aneurysms treated with the Cook Zenith endovascular graft (Cook Inc, Bloomington, Ind).
Between September 1998 and October 2003, 143 patients underwent elective endovascular aneurysm repair (EVAR) using the Cook Zenith endograft. Data from these patients were reviewed from a prospective database in October 2008. Primary outcome measures were overall survival, intervention-free survival, and freedom from aneurysm rupture. Secondary outcome measures were early and late postoperative complications, including endoleaks.
Mean follow-up was 66.4 months (range, 1.9-121.0 months). Overall survival was 72.1% at the 5-year follow-up and 50.9% at the 8-year follow-up. Intervention-free survival was 77.1% at 5 years and 63.8% at 8 years. There were no reintervention-related deaths. Six patients had a late aneurysm rupture, which was fatal in three. Freedom from aneurysm rupture was 98.1% at 5 years and 91.0% at 8 years. Late complications occurred throughout the follow-up period, with a tendency for aneurysm rupture and surgical conversion to occur at a later stage in the follow-up period. Aneurysm sac enlargement during follow-up was associated with late aneurysm rupture and with the need for reintervention.
Elective EVAR using the Cook Zenith endograft provides excellent results through a mean follow-up of >5 years. There is a low aneurysm-related mortality and an acceptable rate of postoperative complications and reinterventions. The occurrence of late complications throughout the follow-up period stresses the need for continued postoperative surveillance in EVAR patients.
本研究评估了使用 Cook Zenith 血管内移植物治疗腹主动脉和主动脉-髂动脉瘤患者的长期结果。
1998 年 9 月至 2003 年 10 月，143 例患者接受了择期血管内动脉瘤修复术（EVAR），使用 Cook Zenith 血管内移植物。2008 年 10 月，从前瞻性数据库中回顾了这些患者的数据。主要观察指标为总生存率、无干预生存率和免于动脉瘤破裂。次要观察指标为早期和晚期术后并发症，包括内漏。
平均随访时间为 66.4 个月（范围为 1.9-121.0 个月）。5 年随访时总体生存率为 72.1%，8 年随访时为 50.9%。5 年无干预生存率为 77.1%，8 年为 63.8%。无再干预相关死亡。6 例患者发生晚期动脉瘤破裂，其中 3 例死亡。5 年免于动脉瘤破裂的比例为 98.1%，8 年为 91.0%。晚期并发症发生在整个随访期间，动脉瘤破裂和手术转换倾向于在随访后期发生。随访期间的动脉瘤囊扩大与晚期动脉瘤破裂和需要再次干预有关。
通过>5 年的平均随访，使用 Cook Zenith 血管内移植物的择期 EVAR 提供了出色的结果。动脉瘤相关死亡率低，术后并发症和再次干预率可接受。在整个随访期间发生晚期并发症强调了 EVAR 患者需要持续的术后监测。
