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II型内漏栓塞术的比较:仅栓塞内漏瘤巢与栓塞内漏瘤巢及分支血管

Comparison of Type II Endoleak Embolizations: Embolization of Endoleak Nidus Only versus Embolization of Endoleak Nidus and Branch Vessels.

作者信息

Yu Hyeon, Desai Hemant, Isaacson Ari J, Dixon Robert G, Farber Mark A, Burke Charles T

机构信息

Division of Vascular and Interventional Radiology, Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.

Division of Vascular Surgery, Department of Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.

出版信息

J Vasc Interv Radiol. 2017 Feb;28(2):176-184. doi: 10.1016/j.jvir.2016.10.002. Epub 2016 Dec 18.

Abstract

PURPOSE

To compare outcomes of type II endoleak embolization involving embolization of the endoleak nidus only vs embolization of the endoleak nidus and branch vessels in patients treated with endovascular repair of abdominal aortic aneurysms.

MATERIALS AND METHODS

Twenty-nine consecutive patients (mean age, 77.9 y; range, 63-88 y) with type II endoleak who underwent embolization from 2004 to 2015 were retrospectively reviewed. Patients were divided into 2 groups: embolization of endoleak nidus only (group A) and embolization of endoleak nidus and branch vessels (group B). Mean follow-up intervals were 20.5 months ± 14.7 in group A and 24.3 months ± 18.5 in group B. Outcomes were compared between groups by Mann-Whitney U and Pearson χ tests.

RESULTS

Mean interval from endovascular aneurysm repair to embolization was 47.6 months ± 42.9, and mean presentation time of endoleak before embolization was 23.1 months ± 25.8. Coils (n = 28) and liquid embolic agents (n = 23) were used for embolization. There were no significant differences in rates of residual endoleak (50% vs 53.8%; P = .96) or sac decrease/stabilization (62.5% vs 61.5%; P = .64). Procedure time and radiation exposure in group B (132.3 min ± 78.1; 232.4 Gy·cm ± 130.7) were greater than in group A (63.4 min ± 11.9; 61.5 Gy·cm ± 35.5; P < .01). There were no procedure-related complications.

CONCLUSIONS

Embolization of the endoleak nidus and branch vessels is not superior to embolization of only the nidus in terms of occlusion of type II endoleak and change in sac size despite requiring longer procedure times and resulting in greater patient radiation exposure.

摘要

目的

比较在接受腹主动脉瘤血管腔内修复术的患者中,仅栓塞内漏瘤巢与栓塞内漏瘤巢及分支血管的II型内漏栓塞治疗效果。

材料与方法

回顾性分析2004年至2015年间连续29例接受栓塞治疗的II型内漏患者(平均年龄77.9岁;范围63 - 88岁)。患者分为两组:仅栓塞内漏瘤巢(A组)和栓塞内漏瘤巢及分支血管(B组)。A组平均随访间隔为20.5个月±14.7,B组为24.3个月±18.5。采用Mann - Whitney U检验和Pearson χ检验比较两组的治疗效果。

结果

从血管腔内动脉瘤修复到栓塞的平均间隔时间为47.6个月±42.9,栓塞前内漏的平均出现时间为23.1个月±25.8。使用弹簧圈(n = 28)和液体栓塞剂(n = 23)进行栓塞。残余内漏率(50%对53.8%;P = 0.96)或瘤腔缩小/稳定率(62.5%对61.5%;P = 0.64)无显著差异。B组的手术时间(132.3分钟±78.1)和辐射暴露量(232.4 Gy·cm±130.7)大于A组(63.4分钟±11.9;61.5 Gy·cm±35.5;P < 0.01)。无手术相关并发症。

结论

尽管栓塞内漏瘤巢及分支血管需要更长的手术时间并导致患者接受更多辐射暴露,但在II型内漏闭塞和瘤腔大小变化方面,其并不优于仅栓塞瘤巢。

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