Department of Vascular Surgery, Aichi Medical University Hospital, Nagakute, Aichi, 480-1195, Japan.
Surg Today. 2011 Dec;41(12):1605-9. doi: 10.1007/s00595-011-4531-1. Epub 2011 Oct 4.
To evaluate the mid-term results of endovascular repair of abdominal aortic aneurysms and to predict subsequent sac shrinkage.
From December 2006 to April 2010, 114 abdominal aortic aneurysms were treated with stent grafts. The intraoperative sac pressure was measured by a microcatheter. Correlations between the diameter change and relevant factors were determined by a logistic regression analysis.
Stent grafts were deployed successfully in all patients. Type-2 endoleaks were noted in 25 patients (22%); there were no type-1 or type-3 endoleaks at discharge. The clinical success rate was 99%. The diameter was reduced in 40 patients (56%) but remained unchanged in 32 (44%). There were no aneurysms that increased in diameter. At 2 years after the repair the rate of cumulative survival was 87% and freedom from secondary intervention was 95%. The sac pressure index after stent grafting with a reduced diameter was 0.56 ± 0.11 and that of patients with an unchanged diameter was 0.52 ± 0.14. There were no significant differences between the two groups. Persistent type-2 endoleaks had a slightly negative effect on sac shrinkage (P = 0.052).
The mid-term results of endovascular aneurysm repair were satisfactory. Although it was difficult to predict the fate of a sac after stent grafting, persistent type-2 endoleaks were observed to have a slightly negative impact on sac shrinkage.
评估腹主动脉瘤血管内修复的中期结果并预测随后的瘤囊缩小情况。
2006 年 12 月至 2010 年 4 月，114 例腹主动脉瘤患者接受了支架移植物治疗。术中通过微导管测量瘤囊内压力。通过逻辑回归分析确定直径变化与相关因素之间的相关性。
所有患者均成功植入支架移植物。25 例（22%）患者出现 2 型内漏；出院时无 1 型或 3 型内漏。临床成功率为 99%。40 例（56%）患者的直径缩小，但 32 例（44%）患者的直径不变。没有瘤囊增大的情况。修复后 2 年，累积生存率为 87%，二次干预的无瘤生存率为 95%。直径缩小的支架移植物后瘤囊压力指数为 0.56 ± 0.11，直径不变的患者为 0.52 ± 0.14。两组间无显著差异。持续存在的 2 型内漏对瘤囊缩小有轻微的负面影响（P = 0.052）。
血管内动脉瘤修复的中期结果令人满意。尽管难以预测支架移植物后瘤囊的命运，但持续存在的 2 型内漏对瘤囊缩小有轻微的负面影响。
