Lee Seung Hyun, Won Jong Yun, Lee Do Yun, Kim Il Jung, Lee Shin Jae, Kim Man Deuk, Park Sung Il, Lee Kwang Hun, Ko Young Guk, Choi Dong-Hoon, Kim Eun-Kyung
Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University, College of Medicine, Seoul, Republic of Korea.
Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University, College of Medicine, Seoul, Republic of Korea
Acta Radiol. 2015 Mar;56(3):304-11. doi: 10.1177/0284185114526591. Epub 2014 Mar 7.
Endovascular aneurysm repair (EVAR) has been suggested as treatment for inflammatory abdominal aortic aneurysms (IAAA), but the actual clinical and radiological outcomes need to be evaluated.
To report morphological changes in EVAR of IAAAs.
Ten male patients (mean age, 67 years; range, 54-78 years) with IAAA were treated with EVAR using endovascular stent-grafts between March 2001 and January 2012. We retrospectively compared computed tomography angiography (CTA) images taken immediately (30 days after the EVAR), short-term (up to 1 year), and mid-term (beyond 1 year) to CTA images taken before the EVAR. Clinical success was defined as successful deployment of the stent-graft without a type I or III endoleak. Morphologic responses of IAAA to EVAR were reviewed by measuring the changes in aneurysm sac maximum diameter (mm), periaortic fibrosis (PAF) thickness (mm), and PAF enhancement (Hounsfield units [HU] on delayed CTA) on serial images.
Ten IAAA patients treated with EVAR were followed for a mean of 42 months (range, 7-129 months). No aneurysm-related deaths were observed during the follow-up of 10 patients. Primary clinical success was achieved in seven patients, assisted primary clinical success in one patient, and secondary clinical success in two patients. Aneurysm sac maximum diameter decreased in all patients (mean percentage reduction of 7.6%, 8.5%, and 17.3% in immediate, short-term, and mid-term follow-up CTA, respectively). PAF thickness decreased in eight patients (10.4%, 16.8%, and 27.2% regression upon follow-up). PAF enhancement decreased in nine patients and increased in one patient (mean percentage decrease of 13.0%, 27.3%, and 40.8% upon follow-up).
Treatment of IAAA with EVAR was effective and reduced aneurysmal sac diameter and the extent of PAF with acceptable morbidity.
血管内动脉瘤修复术（EVAR）已被提议用于治疗炎性腹主动脉瘤（IAAA），但实际的临床和影像学结果有待评估。
报告IAAA的EVAR术后形态学变化。
2001年3月至2012年1月期间，10例男性IAAA患者（平均年龄67岁；范围54 - 78岁）接受了使用血管内支架移植物的EVAR治疗。我们回顾性地将EVAR术后即刻（术后30天）、短期（至1年）和中期（超过1年）的计算机断层扫描血管造影（CTA）图像与EVAR术前的CTA图像进行比较。临床成功定义为成功植入支架移植物且无I型或III型内漏。通过测量系列图像上动脉瘤囊最大直径（mm）、主动脉周围纤维化（PAF）厚度（mm）和PAF强化（延迟CTA上的亨氏单位[HU]）的变化，回顾IAAA对EVAR的形态学反应。
10例接受EVAR治疗的IAAA患者平均随访42个月（范围7 - 129个月）。10例患者随访期间未观察到与动脉瘤相关的死亡。7例患者取得了初次临床成功，1例患者取得了辅助性初次临床成功，2例患者取得了二次临床成功。所有患者的动脉瘤囊最大直径均减小（即刻、短期和中期随访CTA时平均减小百分比分别为7.6%、8.5%和17.3%）。8例患者的PAF厚度减小（随访时分别消退10.4%、16.8%和27.2%）。9例患者的PAF强化降低，1例患者升高（随访时平均降低百分比分别为13.0%、27.3%和40.8%）。
EVAR治疗IAAA有效，可减小动脉瘤囊直径并减轻PAF程度，且发病率可接受。
Zotero 插件