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使用Viabahn血管内支架修复腘动脉瘤的十年经验:来自两个意大利血管中心的报告

Ten years' experience in endovascular repair of popliteal artery aneurysm using the Viabahn endoprosthesis: a report from two Italian vascular centers.

作者信息

Speziale Francesco, Sirignano Pasqualino, Menna Danilo, Capoccia Laura, Mansour Wassim, Serrao Eugenia, Ronchey Sonia, Alberti Vittorio, Esposito Andrea, Mangialardi Nicola

机构信息

Vascular and Endovascular Surgery Division, Department of Surgery "Paride Stefanini", Policlinico Umberto I, "Sapienza" University of Rome, Rome, Italy.

Vascular and Endovascular Surgery Division, Department of Surgery "Paride Stefanini", Policlinico Umberto I, "Sapienza" University of Rome, Rome, Italy.

出版信息

Ann Vasc Surg. 2015 Jul;29(5):941-9. doi: 10.1016/j.avsg.2015.01.008. Epub 2015 Mar 7.

DOI:10.1016/j.avsg.2015.01.008
PMID:25757986
Abstract

BACKGROUND

Although rare, popliteal artery aneurysms (PAAs) are the most commonly observed peripheral arterial aneurysms. Surgical repair is considered the gold standard, even if with debated results. The aim of our study is to evaluate the outcome of endovascular treatment of PAAs using the Viabahn peripheral endograft (W. L. Gore and Associates, Inc., Flagstaff, AZ) in 2 high-volume Italian centers.

METHODS

All consecutive PAA patients treated by endovascular procedures between January 2004 and December 2013 were retrospectively reviewed. True atherosclerotic aneurysms, symptomatic and asymptomatic, were included in the analysis. All patients were treated by high-skilled vascular surgeons. The outcome measures were graft thrombosis, reintervention rate, and limb salvage at early and long-term follow-up.

RESULTS

Fifty-three PAAs were treated. Patients were more frequently male (98.1%) with a mean age of 73.6 ± 7.8 years. Twelve patients (22.6%) were symptomatic and in 8 of them a local fibrinolysis was required before definitive surgery. Mean PAA diameter was 30.9 ± 10.9 mm (range 17-60). Fifty-two patients (98.1%) had at least 1 patent runoff vessel. Technical success was achieved in all patients. Overall, 80 stent grafts were deployed and in 21 patients (39.6%) more than 1 stent graft was deployed. In-hospital mortality rate and 30-day reinterventions were null. At a mean follow-up of 37.4 ± 29.3 months, primary patency, secondary patency, and limb salvage were respectively 73.6%, 92.4%, and 100%.

CONCLUSION

In our limited, retrospective experience, the endovascular treatment of PAA by Viabahn stent graft allowed satisfactory technical and clinical results even at long-term follow-up.

摘要

背景

虽然腘动脉动脉瘤(PAA)较为罕见,但却是最常观察到的周围动脉动脉瘤。手术修复被视为金标准,即便其结果存在争议。我们研究的目的是在意大利的2个高容量中心评估使用威博恩外周血管内移植物(W. L. 戈尔联合公司,亚利桑那州弗拉格斯塔夫)对PAA进行血管内治疗的结果。

方法

对2004年1月至2013年12月期间接受血管内手术治疗的所有连续性PAA患者进行回顾性分析。分析纳入了真性动脉粥样硬化性动脉瘤,包括有症状和无症状的病例。所有患者均由高技能血管外科医生进行治疗。观察指标为早期和长期随访时的移植物血栓形成、再次干预率和肢体挽救情况。

结果

共治疗53例PAA。患者以男性居多(98.1%),平均年龄为73.6±7.8岁。12例患者(22.6%)有症状,其中8例在确定性手术前需要进行局部纤溶治疗。PAA平均直径为30.9±10.9毫米(范围17 - 60)。52例患者(98.1%)至少有1条通畅的流出道血管。所有患者均获得技术成功。总体而言,共植入80枚支架型人工血管,21例患者(39.6%)植入了1枚以上的支架型人工血管。住院死亡率和30天再次干预率为零。平均随访37.4±29.3个月时,一期通畅率、二期通畅率和肢体挽救率分别为73.6%、92.4%和100%。

结论

根据我们有限的回顾性经验,即使在长期随访中,使用威博恩支架型人工血管对PAA进行血管内治疗也能获得满意的技术和临床效果。

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