Georgakarakos Efstratios, Argyriou Christos, Schoretsanitis Nikolaos, Ioannou Chris V, Kontopodis Nikolaos, Morgan Robert, Tsetis Dimitrios
Department of Vascular Surgery, University Hospital of Alexandroupolis, "Democritus" University of Thrace, Alexandroupolis, Greece,
Cardiovasc Intervent Radiol. 2014 Dec;37(6):1420-9. doi: 10.1007/s00270-014-0927-9. Epub 2014 Jun 18.
Endovascular aneurysm repair (EVAR) is considered to be the treatment of choice for abdominal aortic aneurysms (AAA). Despite the initial technical success, EVAR is amenable to early and late complications, among which the migration of the endograft (EG) with subsequent proximal endoleak (Type Ia) leads to repressurization of the AAA sac, exposure to excessive wall stress, and, hence, to potential rupture. This article discusses the influence that certain geometrical factors, such as neck angulation, iliac bifurcation, EG curvature, neck-to-iliac diameter, and length ratios, as well as iliac limbs configuration can exert on the hemodynamic behavior of the EGs. The information provided could help both clinicians and EG manufacturers towards further development and improvement of EG designs and better operational planning.
血管内动脉瘤修复术（EVAR）被认为是腹主动脉瘤（AAA）的首选治疗方法。尽管最初技术上取得了成功，但EVAR仍易出现早期和晚期并发症，其中移植物（EG）移位并随后出现近端内漏（Ia型）会导致AAA瘤腔重新受压，使其承受过大的壁面应力，进而可能破裂。本文讨论了某些几何因素，如颈部角度、髂动脉分叉、EG曲率、颈部与髂动脉直径以及长度比，还有髂支构型对EG血流动力学行为的影响。所提供的信息有助于临床医生和EG制造商进一步开发和改进EG设计，并更好地进行手术规划。
