Krajcer Zvonimir, Rajan Lawrence, Thota Venkata, Dougherty Kathryn G, Strickman Neil E, Mortazavi Ali, Cheong Benjamin Y C
Division of Cardiology, Texas Heart Institute at St. Luke's Episcopal Hospital, TXx 77030, USA.
Tex Heart Inst J. 2011;38(4):381-5.
We sought to compare the efficacy of a low-permeability version of the Gore Excluder™ device with that of the original device. We used volumetric analysis and maximum transverse diameter measurements to examine abdominal aortic aneurysm size regression after endovascular aneurysm repair.From November 2002 through April 2007, 101 patients (82% men; mean age, 71.5 ± 8.9 yr) underwent endovascular aneurysm repair with the Excluder stent-graft: 34 with the original device, and 67 with the low-permeability device. Only patients without endoleak and with preprocedural and 1- and 2-year follow-up computed tomographic scans were included. Eight patients with type II endoleak and 2 with type I endoleak were excluded. Maximum abdominal aortic aneurysm diameter and volume were measured before endovascular aneurysm repair and annually thereafter. Postprocessing, multiplanar computed tomography, and 3-dimensional reconstructions were compared with baseline measurements. Diameter and volume changes that were greater than 5 mm or that exceeded 10% were considered significant.At 12 months, the mean maximum transverse diameter had decreased by -0.16 ± 12.1 mm in recipients of the original device and by -4.8 ± 5.9 mm in recipients of the low-permeability device (P = NS). In addition, mean reduction in volume had changed by -17 ± 16 mL in original-device recipients and by -36.1 ± 37.9 mL in low-permeability device recipients (P < 0.01).One-year follow-up revealed that the low-permeability stent-graft resulted in a greater decrease in abdominal aortic aneurysm volume than did the original stent-graft.
我们试图比较低渗透率版本的戈尔覆膜支架移植物（Gore Excluder™）与原始设备的疗效。我们使用容积分析和最大横径测量来检查血管内动脉瘤修复术后腹主动脉瘤大小的变化。
从2002年11月到2007年4月，101例患者（82%为男性；平均年龄71.5±8.9岁）接受了使用Excluder覆膜支架移植物的血管内动脉瘤修复术：34例使用原始设备，67例使用低渗透率设备。仅纳入无内漏且有术前及1年和2年随访计算机断层扫描的患者。8例II型内漏患者和2例I型内漏患者被排除。在血管内动脉瘤修复术前及此后每年测量腹主动脉瘤的最大直径和体积。将后处理、多平面计算机断层扫描和三维重建与基线测量进行比较。直径和体积变化大于5mm或超过10%被认为具有显著性。
在12个月时，原始设备接受者的平均最大横径减少了-0.16±12.1mm，低渗透率设备接受者的平均最大横径减少了-4.8±5.9mm（P=无显著性差异）。此外，原始设备接受者的平均体积减少了-17±16mL，低渗透率设备接受者的平均体积减少了-36.1±37.9mL（P<0.01）。
一年的随访显示，低渗透率覆膜支架移植物导致腹主动脉瘤体积的减少比原始覆膜支架移植物更大。
