Kalteis Manfred, Haller Florian, Artmann Andreas, Ratzenböck Markus, Hartl Peter, Lugmayr Herbert
Departments of Cardiac, Vascular and Thoracic Surgery, Klinikum Wels-Grieskirchen, Wels, Austria.
Ann Vasc Surg. 2012 Apr;26(3):330-7. doi: 10.1016/j.avsg.2011.06.012. Epub 2012 Jan 30.
The purpose of this study is to report the results of endovascular abdominal aortic aneurysm treatment based on the Zenith stent-graft from a community-based single center over a period of 9 years.
We retrospectively analyzed immediate technical and clinical results as well as long-term outcomes in patients treated with endovascular aneurysm repair between 2001 and 2010. The study was performed in accordance with the recommendations of the ad hoc committee for standardized reporting practice in vascular surgery.
A total of 106 patients were treated in a period of 9 years. A Zenith stent-graft was used in 95% of cases. No deaths occurred during the first 30 days postsurgery. The complication rate was 4.7% (n = 5). The overall clinical and technical success rate at 30 days was 93.4%. After a mean follow-up period of 52 months (range, 13-112 months), the overall mortality rate was 25.4%. Aneurysm-related mortality was 2.1%. Rupture of the aneurysm occurred in four cases (4.3%). The final clinical failure rate was 13.8%. During the follow-up period, the mean diameter of the aneurysm decreased from 58.0 to 52.3 mm. However, expansion of the aneurysm was registered in 10 cases. Eleven patients had a primary endoleak, and another 11 secondary endoleaks occurred during the follow-up. The reintervention rate was 16.3%. The main reasons for repeat interventions were iliac limb occlusion (n = 5) and type 3 endoleak/limb disconnection (n = 4). Graft migration occurred in 3% of cases. A negative impact on sexual function after endovascular repair was reported by 20% of patients.
Endovascular repair is the treatment of choice for high-risk patients. A small but significant number of clinical failures were observed during the long-term follow-up.
本研究旨在报告基于Zenith覆膜支架移植物，在一个社区单中心进行的为期9年的腹主动脉瘤血管内治疗结果。
我们回顾性分析了2001年至2010年间接受血管内动脉瘤修复术患者的即刻技术和临床结果以及长期预后。本研究是按照血管外科标准化报告实践特设委员会的建议进行的。
9年期间共治疗了106例患者。95%的病例使用了Zenith覆膜支架移植物。术后30天内无死亡病例。并发症发生率为4.7%（n = 5）。30天时的总体临床和技术成功率为93.4%。平均随访期为52个月（范围13 - 112个月）后，总死亡率为25.4%。动脉瘤相关死亡率为2.1%。动脉瘤破裂发生4例（4.3%）。最终临床失败率为13.8%。随访期间，动脉瘤平均直径从58.0 mm降至52.3 mm。然而，10例出现动脉瘤扩张。11例患者发生原发性内漏，随访期间又有11例发生继发性内漏。再次干预率为16.3%。再次干预的主要原因是髂支闭塞（n = 5）和3型内漏/肢体断开（n = 4）。3%的病例发生了移植物移位。20%的患者报告血管内修复后对性功能有负面影响。
血管内修复是高危患者的首选治疗方法。长期随访期间观察到少量但显著的临床失败病例。
