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定制开窗型安那康达主动脉支架移植物的手术及1年随访结果:一项英国多中心研究

Operative and 1-Year Outcomes of the Custom-Made Fenestrated Anaconda Aortic Stent Graft-A UK Multicenter Study.

作者信息

Colgan Frances E, Bungay Peter M, Burfitt Nicholas, Hatrick Andrew, Clarke Michael J, Davies Alun H, Jenkins Michael, Gerrard David, Quarmby John W, Williams Robin

机构信息

The Northern Vascular Centre, Freeman Hospital, Newcastle-upon-Tyne Hospitals NHS Trust, Newcastle-upon-Tyne, UK.

Department of Vascular Surgery and Interventional Radiology, Royal Derby Hospital, Derby, UK.

出版信息

Ann Vasc Surg. 2018 Jan;46:257-264. doi: 10.1016/j.avsg.2017.05.027. Epub 2017 Jun 12.

Abstract

BACKGROUND

Early and 1-year outcomes are presented for fenestrated endovascular aneurysm repair (FEVAR) of complex aortic aneurysmal disease with the custom-made Anaconda fenestrated stent graft in 101 patients.

METHODS

Retrospective site-reported data from the first 101 elective cases (2010-2014) from 4 UK centers were studied to evaluate patient demographics, aneurysm morphology, clinical success, and 1-year outcomes in patients undergoing fenestrated aneurysm repair with the custom-made Anaconda device.

RESULTS

101 fenestrated grafts (median age 76, 85% male) were implanted with a total of 255 fenestrations (196 renal arteries, 48 superior mesenteric artery, and 11 celiac arteries) with 3% mortality, 98.4% target vessel patency (TVP) at 30 day follow-up. Although 15 type I or III endoleaks were demonstrated at completion angiography, all 10 type Ia endoleaks resolved spontaneously. Survival by Kaplan-Meier analysis was 97% and 91% at 1 month and 1 year, respectively; with 75.8% showing reduction in abdominal aortic aneurysm diameter and only 1 patient with sac expansion. Freedom from loss of TVP was 97.6%.

CONCLUSIONS

Custom-made fenestrated Anaconda devices demonstrate low procedural mortality and a high rate of technical and clinical success at 30 days and 1 year.

摘要

背景

本研究报告了101例采用定制的Anaconda开窗支架型人工血管对复杂主动脉瘤疾病进行开窗血管内动脉瘤修复(FEVAR)的早期和1年结局。

方法

对来自英国4个中心的前101例择期病例(2010 - 2014年)的回顾性现场报告数据进行研究,以评估接受定制Anaconda装置开窗动脉瘤修复患者的人口统计学特征、动脉瘤形态、临床成功率和1年结局。

结果

植入了101个开窗移植物(中位年龄76岁,85%为男性),共255个开窗(196个肾动脉、48个肠系膜上动脉和11个腹腔动脉),死亡率为3%,30天随访时靶血管通畅率(TVP)为98.4%。尽管在完成血管造影时发现了15例I型或III型内漏,但所有10例Ia型内漏均自发消失。根据Kaplan - Meier分析,1个月和1年时的生存率分别为97%和91%;75.8%的患者腹主动脉瘤直径缩小,只有1例患者瘤体增大。无TVP丧失的比例为97.6%。

结论

定制的开窗Anaconda装置在30天和1年时显示出较低的手术死亡率以及较高的技术和临床成功率。

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