Verhoeven E L G, Katsargyris A, Oikonomou K, Kouvelos G, Renner H, Ritter W
Department of Vascular and Endovascular Surgery, Paracelsus Medical University, Nuremberg, Germany.
Department of Vascular and Endovascular Surgery, Paracelsus Medical University, Nuremberg, Germany.
Eur J Vasc Endovasc Surg. 2016 Jun;51(6):775-81. doi: 10.1016/j.ejvs.2015.12.014. Epub 2016 Feb 6.
The outcomes of fenestrated endovascular aneurysm repair (FEVAR) as a first line strategy is reported.
All consecutive patients treated with FEVAR for short neck, juxtarenal, or suprarenal aortic aneurysms under the guidance of the senior author within the period January 2010 to December 2014 were included. Data were collected from a prospectively maintained database. Analyzed outcomes included technical success, defined by successful stent graft implantation with patent stented target vessels and no Type I/III endoleak, operative mortality and morbidity, target vessel patency, endoleak, re-intervention, and death. Survival, target vessel stent patency, and re-intervention during follow up were calculated by Kaplan-Meier analysis.
A total of 281 patients (245 male, mean age 72.1 ± 7.7 years) were treated. The mean aneurysm diameter was 60.2 ± 9.3 mm and median proximal neck length 2 mm (range 0-10 mm). Technical success was 96.8% (272/281). Technical failure included one intra-operative death due to embolization and cardiac arrest, one open conversion due to iliac rupture, and seven target vessel complications. The thirty day mortality was 0.7% (2/281). Mean follow up was 21 ± 15.9 months. Estimated survival at 1 and 3 years was 94.7% ± 1.6% and 84.6% ± 3.0%, respectively. Estimated freedom from re-intervention at 1 and 3 years was 96.1% ± 1.4%, and 90% ± 2.7%. Estimated target vessel stent patency at 1 and 3 years was 98.6% ± 0.5%, and 98.1% ± 0.6%, respectively. Mean aneurysm sac diameter decreased from 60.2 ± 9.3 mm pre-operatively to 53.2 ± 12.8 mm (p < .001).
FEVAR as a first line strategy was associated with high technical success and a low operative mortality rate. Efficacy and durability in the mid-term appear very good, with significant regression of aneurysm sac diameter, high target vessel patency, and acceptable rate of re-intervention.
报告开窗式血管内动脉瘤修复术（FEVAR）作为一线治疗策略的治疗结果。
纳入2010年1月至2014年12月期间在资深作者指导下接受FEVAR治疗短颈、肾旁或肾上腹主动脉瘤的所有连续患者。数据来自前瞻性维护的数据库。分析的结果包括技术成功，定义为成功植入支架移植物且支架置入的目标血管通畅且无I/III型内漏、手术死亡率和发病率、目标血管通畅情况、内漏、再次干预和死亡。随访期间的生存率、目标血管支架通畅率和再次干预情况通过Kaplan-Meier分析计算。
共治疗281例患者（245例男性，平均年龄72.1±7.7岁）。动脉瘤平均直径为60.2±9.3mm，近端颈部长度中位数为2mm（范围0-10mm）。技术成功率为96.8%（272/281）。技术失败包括1例因栓塞和心脏骤停导致的术中死亡、1例因髂动脉破裂导致的开放手术转换以及7例目标血管并发症。30天死亡率为0.7%（2/281）。平均随访时间为21±15.9个月。1年和3年的估计生存率分别为94.7%±1.6%和84.6%±3.0%。1年和3年的估计无再次干预率分别为96.
