Interventional Radiology, Department of Radiology, University of Insubria, Viale Borri 57, 21100, Varese, Italy.
Radiol Med. 2012 Apr;117(3):410-25. doi: 10.1007/s11547-011-0717-2. Epub 2011 Sep 2.
This study evaluated the safety and technical and clinical success rates of positioning endovascular endografts (EG) in ruptured abdominal aneurysms.
Patients with a ruptured abdominal aortic aneurysm confirmed by contrast-enhanced computed tomography angiography (CTA) were eligible for the analysis. Of 67 patients, 42 (62.7%) were treated with EG. Thirteen patients (30.9%) received an aorto-uni-iliac EG (group A) and 29 a bifurcated EG (group B). Patients were divided for comparative analysis according to the configuration of the EG implanted.
The primary technical success rate was 100%; the primary clinical success rate was 95% (40/42). There were two intraoperative deaths (4.7%) related to intractable shock. No patient required conversion to open repair. Overall, 12 patients (28.5%) died within 30 days. The in-hospital death rate was 30.9% (13/42). Hospital mortality rate was statistically higher in group A; the type of EG and intensive care unit admission were the only independent predictors of hospital mortality.
In our experience, a higher mortality rate was observed for the aorto-uni-iliac configuration; shock at admission was confirmed as the most important factor for postoperative survival.
本研究评估了在破裂性腹主动脉瘤中定位血管内内支架移植物（EG）的安全性以及技术和临床成功率。
符合增强 CT 血管造影（CTA）证实的破裂性腹主动脉瘤的患者有资格进行分析。67 例患者中，42 例（62.7%）接受了 EG 治疗。13 例（30.9%）接受了腹主动脉-单-髂动脉 EG（A 组），29 例接受了分叉 EG（B 组）。根据植入的 EG 构型，患者被分为两组进行比较分析。
主要技术成功率为 100%；主要临床成功率为 95%（40/42）。有 2 例术中死亡（4.7%）与难治性休克有关。无患者需要转为开放修复。总体而言，12 例患者（28.5%）在 30 天内死亡。住院死亡率为 30.9%（13/42）。A 组的住院死亡率更高；EG 类型和重症监护病房入院是住院死亡率的唯一独立预测因素。
根据我们的经验，腹主动脉-单-髂动脉构型的死亡率更高；入院时休克被证实是术后生存的最重要因素。
