Libicher Martin, Pavlidis Daphne, Bangard Christopher, Gawenda Michael
Department of Diagnostic and Interventional Radiology, Deaconess Hospital, Schwäbisch Hall, Germany.
Vasc Endovascular Surg. 2012 Jan;46(1):34-9. doi: 10.1177/1538574411427786. Epub 2011 Dec 8.
We compared occlusion of the internal iliac artery (IIA) using coils or the Amplatzer vascular plug (AVP) II prior to endovascular aortic aneurysm repair.
Occlusion of the IIA was performed in 32 patients (aged 74 ± 8 years) using coils (N = 17) or the AVP II (N = 15). We retrospectively compared procedural data, initial success, and clinical outcome in a 12-month follow-up.
Occlusion was successful in all patients without detection of an endoleak after 12 months. Procedure time and fluoroscopy time for coils versus plugs were 77 ± 35 versus 43 ± 13 minutes and 36 ± 19 versus 18 ± 8 minutes, respectively (P < .003). Incidence of initial buttock claudication (BC) for coils versus plugs was 47% versus 27% and was significantly more severe after coil occlusion (P = .03). After a 12-month follow-up, 2 patients of each group reported of mild BC.
Occlusion of the IIA is safe and effective using coils or plugs. Initial BC is significantly more severe when coils are used, but after a 12-month follow-up, there is no significant difference. Using a plug is associated with a significant reduction of procedure time and radiation exposure.
我们比较了在血管腔内主动脉瘤修复术前使用弹簧圈或Amplatzer血管封堵器（AVP）II封堵髂内动脉（IIA）的效果。
对32例患者（年龄74±8岁）进行IIA封堵，其中17例使用弹簧圈，15例使用AVP II。我们回顾性比较了手术数据、初始成功率以及12个月随访期内的临床结果。
所有患者封堵均成功，12个月后未检测到内漏。弹簧圈组与封堵器组的手术时间分别为77±35分钟和43±13分钟，透视时间分别为36±19分钟和18±8分钟（P<.003）。弹簧圈组与封堵器组初始臀部间歇性跛行（BC）的发生率分别为47%和27%，弹簧圈封堵后BC明显更严重（P=.03）。12个月随访后，每组各有2例患者报告有轻度BC。
使用弹簧圈或封堵器封堵IIA安全有效。使用弹簧圈时初始BC明显更严重，但12个月随访后无显著差异。使用封堵器可显著缩短手术时间并减少辐射暴露。
