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使用戈尔TAG装置对退行性降主动脉瘤进行血管内治疗的中期结果。

Mid-term results of endovascular treatment with the Gore TAG device for degenerative descending thoracic aortic aneurysms.

作者信息

Yunoki Junji, Kuratani Toru, Shirakawa Yukitoshi, Torikai Kei, Shimamura Kazuo, Kin Keiwa, Sawa Yoshiki

机构信息

Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan,

出版信息

Gen Thorac Cardiovasc Surg. 2015 Jan;63(1):38-42. doi: 10.1007/s11748-014-0436-4. Epub 2014 Jun 17.

Abstract

PURPOSE

To confirm the validity of using Gore TAG for degenerative descending thoracic aneurysm repair, we evaluated the mid-term clinical outcomes in our single-center experience.

METHODS

From May 2008 to April 2011, elective thoracic endovascular aortic repair (TEVAR) with Gore TAG without left subclavian artery (LSA) coverage for a degenerative descending thoracic aneurysm was performed in 36 consecutive cases.

RESULTS

The procedural success rate was 100%, and no patient died within 30 days of the operation. We observed no cases of paraplegia or stroke. The mean follow-up was 33.2 ± 13.0 months (the maximum follow-up was 58.0 months). The actuarial survival rate was 100, 97.2 and 94.4% at 1, 2 and 3 years. There was no aorta-related death at 3 years. Two (5.6%) late distal Type I endoleaks were observed. Freedom form aortic events rate was 97.2, 97.2, and 97.2% at 1, 2, and 3 years respectively. In six cases with bird-beak configurations at the 2-year follow-up, the bird-beak length and angle had increased gradually.

CONCLUSIONS

Elective TEVAR using the Gore TAG for degenerative descending thoracic aortic aneurysms without LSA coverage is effective and provides satisfactory early and mid-term outcomes. However, since the bird-beak configurations progressed, a conformable and flexible device for the next generation of procedures will be needed.

摘要

目的

为证实使用戈尔TAG(Gore TAG)修复退行性降主动脉瘤的有效性,我们评估了单中心经验中的中期临床结果。

方法

2008年5月至2011年4月,连续36例患者接受了使用戈尔TAG且未覆盖左锁骨下动脉(LSA)的选择性胸主动脉腔内修复术(TEVAR)治疗退行性降主动脉瘤。

结果

手术成功率为100%,术后30天内无患者死亡。未观察到截瘫或中风病例。平均随访时间为33.2±13.0个月(最长随访时间为58.0个月)。1年、2年和3年的精算生存率分别为100%、97.2%和94.4%。3年时无主动脉相关死亡。观察到2例(5.6%)晚期远端I型内漏。1年、2年和3年时无主动脉事件发生率分别为97.2%、97.2%和97.2%。在2年随访时有6例呈鸟嘴样形态,鸟嘴长度和角度逐渐增加。

结论

使用戈尔TAG对退行性降主动脉瘤进行选择性TEVAR且不覆盖LSA是有效的,并能提供满意的早期和中期结果。然而,由于鸟嘴样形态进展,未来需要一种顺应性和灵活性更好的器械用于手术。

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