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使用无覆膜支架辅助弹簧圈栓塞术治疗宽基底肾动脉瘤

Management of wide-based renal artery aneurysms using noncovered stent-assisted coil embolization.

作者信息

Wei Xiaolong, Sun Yudong, Wu Yani, Li Zhenjiang, Zhu Jiang, Zhao Zhiqing, Feng Rui, Jing Zaiping

机构信息

Department of Vascular Surgery, Changhai Hospital, Second Military Medical University, Shanghai, China.

Department of Vascular Surgery, Changhai Hospital, Second Military Medical University, Shanghai, China.

出版信息

J Vasc Surg. 2017 Sep;66(3):850-857. doi: 10.1016/j.jvs.2017.04.035. Epub 2017 Jun 19.

Abstract

OBJECTIVE

This study describes the safety and midterm efficacy of a noncovered stent-assisted embolization (SAE) technique in treating patients with wide-base renal artery aneurysms (RAAs).

METHODS

Between February 2011 and June 2014, 34 RAAs in 28 consecutive patients were treated with noncovered SAE in our center.

RESULTS

Technical success was 100%. During an average follow-up of 19 months, the systolic and diastolic blood pressures were significantly decreased. Serum creatinine was significantly decreased, and the glomerular filtration rate was significantly increased at the 6 and 12 month follow-up compared with the baseline. The aneurysm sac thrombosis ratio was obviously increased at 1, 6, and 12 months of follow-up. Complications occurred in four patients, including one major, two minor, and one late complication. Computed tomography angiography or digital subtraction angiography demonstrated that the primary patency at 1, 6, and 12 months was 100%, 96%, and 100%, respectively, and primary assisted and secondary patency was 100%, without endoleaks.

CONCLUSIONS

SAE can be safely and effectively performed in patients with wide-based RAAs or those with critical anatomy. It showed a midterm reduction of blood pressure and improvement of renal function in RAA patients.

摘要

目的

本研究描述了无覆膜支架辅助栓塞(SAE)技术治疗宽基底肾动脉动脉瘤(RAA)患者的安全性和中期疗效。

方法

2011年2月至2014年6月,我们中心对28例连续患者的34个RAA进行了无覆膜SAE治疗。

结果

技术成功率为100%。在平均19个月的随访期间,收缩压和舒张压显著降低。与基线相比,在6个月和12个月随访时血清肌酐显著降低,肾小球滤过率显著升高。随访1个月、6个月和12个月时动脉瘤囊血栓形成率明显升高。4例患者出现并发症,包括1例严重并发症、2例轻微并发症和1例晚期并发症。计算机断层血管造影或数字减影血管造影显示,1个月、6个月和12个月时的原发性通畅率分别为100%、96%和100%,原发性辅助通畅率和继发性通畅率均为100%,无内漏。

结论

SAE可安全有效地应用于宽基底RAA患者或解剖结构复杂的患者。它显示出RAA患者中期血压降低和肾功能改善。

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