Henrikson Olof, Roos Håkan, Falkenberg Mårten
Department of Radiology, Sahlgrenska University Hospital, Sweden.
Vascular. 2011 Apr;19(2):77-81. doi: 10.1258/vasc.2010.oa0257.
The aim of this study was to investigate whether the liquid embolic agent Onyx, an ethylene vinyl alcohol copolymer, can be used to seal type 1 endoleaks during endovascular aortic repair (EVAR). Six patients with large aortic aneurysms and remaining type 1 endoleaks during or after EVAR were treated with Onyx embolization through a microcatheter placed in the proximal neck in five cases and in the distal neck in one case. Four of the patients were treated using the chimney technique. The type 1 endoleak was primarily sealed by Onyx in all six patients. There was no distal embolization. Two patients had complications during follow-up. One patient had occlusions of chimney grafts to the renal arteries and to one leg extension. These occlusions were not anatomically related to Onyx embolization. One patient had late stentgraft migration of the Onyx-treated distal neck with aneurysm rupture 18 months after treatment. Early experience of Onyx embolization as a bailout solution of type 1 endoleaks after complicated EVAR is promising. However, effective seal with Onyx does not prevent late stentgraft migration. More reported patients and longer follow-up are necessary to evaluate this new technique.
本研究的目的是调查液体栓塞剂Onyx（一种乙烯-乙烯醇共聚物）是否可用于在血管内主动脉修复术（EVAR）期间封闭Ⅰ型内漏。6例患有大主动脉瘤且在EVAR期间或之后仍存在Ⅰ型内漏的患者接受了Onyx栓塞治疗，其中5例通过放置在近端颈部的微导管进行栓塞，1例通过放置在远端颈部的微导管进行栓塞。4例患者采用烟囱技术治疗。所有6例患者的Ⅰ型内漏均主要通过Onyx封闭。未发生远端栓塞。2例患者在随访期间出现并发症。1例患者的肾动脉烟囱移植物和一条腿部延伸移植物发生闭塞。这些闭塞与Onyx栓塞在解剖学上无关。1例患者在治疗18个月后，经Onyx治疗的远端颈部发生晚期支架移植物移位并伴有动脉瘤破裂。Onyx栓塞作为复杂EVAR后Ⅰ型内漏的补救解决方案的早期经验很有前景。然而，用Onyx有效封闭并不能防止晚期支架移植物移位。需要更多的报道病例和更长时间的随访来评估这项新技术。
