O'Connor Paul J, Lookstein Robert A
Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, New York.
Division of Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, New York.
Semin Intervent Radiol. 2015 Sep;32(3):272-7. doi: 10.1055/s-0035-1558466.
Type 2 endoleak (T2EL) is the most common complication following endovascular aneurysm repair (EVAR) for abdominal aortic aneurysms. The management of T2ELs is controversial due to the relatively low incidence of negative outcomes when secondary intervention is avoided. Some studies challenge this practice as demonstrated by adverse events following conservative treatment of T2ELs. Evidence has shown that the preoperative computed tomographic angiogram can predict the development of T2EL based on a patient's arterial anatomy, specifically vessels associated with increased rates of post-EVAR endoleak development. Preoperative embolization of those aortic branch vessels associated with T2ELs has shown decreased rates of postoperative complications and may result in a decreased need for surveillance and reintervention.
2型内漏(T2EL)是腹主动脉瘤血管内修复术(EVAR)后最常见的并发症。由于避免二次干预时不良后果的发生率相对较低,T2EL的处理存在争议。一些研究对这种做法提出了质疑,T2EL保守治疗后的不良事件就证明了这一点。有证据表明,术前计算机断层血管造影可以根据患者的动脉解剖结构,特别是与EVAR术后内漏发生率增加相关的血管,预测T2EL的发生。对与T2EL相关的主动脉分支血管进行术前栓塞已显示术后并发症发生率降低,并可能减少监测和再次干预的需求。