Irace Luigi, Venosi Stefano, Gattuso Roberto, Laurito Antonella, Pompa Valentina, Pasinati Giacomo, Bresadola Luciano
Department of Vascular Surgery, Policlinico Umberto I, "Sapienza" University, Rome, Italy -
J Cardiovasc Surg (Torino). 2016 Dec;57(6):846-852. Epub 2014 Jan 16.
Aim of the study was to evaluate the initial results of endovascular aneurysm repair with the Ovation abdominal stent-graft system in patients with challenging aortoiliac anatomy.
The Ovation stent-graft is an ultra-low profile, modular endovascular graft characterized by a 14F OD delivery system, active suprarenal fixation, and polymer-filled proximal rings that allow sealing in short (≥7 mm) proximal necks. Between November 2010 and January 2012, 14 patients with abdominal aortic aneurysms (AAA) (male: 100%, mean age: 76 years, mean AAA diameter: 54 mm) and challenging aortoiliac anatomy were treated with the Ovation endograft at a single centre. Mean patient follow-up was 5 months.
All cases were performed under local or epidural anesthesia. No operative deaths or major complications were noted. A type I endoleak was detected on final angiogram in one case, which was successfully treated with additional ballooning and Palmaz stenting of the hooking landing zone. One patient died at 2 months due to myocardial infarction unrelated to the device or procedure. AAA-related mortality was 0%. No AAA rupture, AAA enlargement, type I or III endoleak, stent migration, access site complication, or conversion to open surgery was reported during follow-up. A type II endoleak was successfully treated with a right lumbar artery embolization at 4 months. Occlusion of an iliac axis was successfully managed with local fibrinolysis and implantation of a covered stent in the external iliac artery.
Initial outcomes of this single-center experience suggest that the Ovation abdominal stent-graft system is a promising treatment in AAA patients with challenging aortoiliac anatomy.
本研究的目的是评估采用Ovation腹主动脉覆膜支架系统对具有挑战性的主髂动脉解剖结构患者进行血管内动脉瘤修复的初步结果。
Ovation覆膜支架是一种超薄型模块化血管内移植物，其特点是外径为14F的输送系统、主动肾上固定以及聚合物填充的近端环，可在短（≥7mm）近端颈部实现密封。2010年11月至2012年1月期间，在单一中心对14例腹主动脉瘤（AAA）患者（男性：100%，平均年龄：76岁，平均AAA直径：54mm）且具有挑战性的主髂动脉解剖结构采用Ovation血管内移植物进行治疗。患者平均随访时间为5个月。
所有病例均在局部或硬膜外麻醉下进行。未观察到手术死亡或重大并发症。1例患者在最终血管造影时检测到I型内漏，通过对钩形着陆区进行额外球囊扩张和植入Palmaz支架成功治疗。1例患者在2个月时因与器械或手术无关的心肌梗死死亡。AAA相关死亡率为0%。随访期间未报告AAA破裂、AAA增大、I型或III型内漏、支架移位、穿刺部位并发症或转为开放手术。1例II型内漏在4个月时通过右腰动脉栓塞成功治疗。髂总动脉闭塞通过局部纤溶和在髂外动脉植入覆膜支架成功处理。
这一单一中心经验的初步结果表明，Ovation腹主动脉覆膜支架系统对于具有挑战性的主髂动脉解剖结构的AAA患者是一种有前景的治疗方法。
