Department of Diagnostic and Interventional Radiology, University Dusseldorf, Medical Faculty, 40225, Dusseldorf, Germany.
Department of General, Viszeral and Pediatric Surgery, University Dusseldorf, Medical Faculty, 40225, Dusseldorf, Germany.
Eur Radiol. 2018 Aug;28(8):3221-3227. doi: 10.1007/s00330-017-5288-8. Epub 2018 Feb 26.
To analyse technical success, complications, and short- and intermediate-term outcomes after heparin-bonded stent graft implantation for the treatment of major abdominal vessel injury after upper abdominal surgery.
This retrospective, IRB-approved analysis included 29 consecutive patients (female: n = 6, male: n = 23, mean age 65.9 ± 11.2 years). All patients underwent angiography and attempted heparin-bonded stent-graft implantation because of a major visceral arterial injury after upper abdominal surgery. Electronic clinical records, angiographic reports and imaging datasets were reviewed to assess technical success and complications. Telephone interviews were performed to obtain follow-up information and to estimate short- (> 30 days) and intermediate-term (> 90 days) outcomes.
Successful stent graft placement was achieved in 82.8% (24/29). Peri-interventional complications were observed in 20.7% (6/29) and delayed, angiography-associated complications were observed in 34.5% (10/29) of the patients. Symptomatic re-bleeding occurred in 24.1% (7/29). Short-term survival (> 30 days) was 72.4% (21/29). Intermediate survival (> 90 days) was 37.9% (11/29).
Treatment of major vascular injuries with heparin-bonded stent grafts is feasible with a high technical success rate. However, survival depends on the underlying surgical condition, making interdisciplinary patient management mandatory.
• Stent graft implantation is challenging, but has a high technical success rate. • Complications are frequent but surgical conversion is rarely necessary. • Survival depends on the underlying surgical condition causing the vascular injury. • Interdisciplinary management is crucial for the survival of these patients.
分析肝素结合支架移植物植入治疗上腹部手术后大血管损伤的技术成功率、并发症及短期和中期结果。
这是一项回顾性的、经 IRB 批准的分析，共纳入 29 例连续患者（女性：n = 6，男性：n = 23，平均年龄 65.9 ± 11.2 岁）。所有患者在上腹部手术后发生大内脏动脉损伤，均进行血管造影并尝试肝素结合支架移植物植入。电子临床记录、血管造影报告和影像学数据集进行了回顾，以评估技术成功率和并发症。通过电话访谈获取随访信息，并估计短期（>30 天）和中期（>90 天）结果。
29 例患者中，82.8%（24/29）成功放置支架移植物。20.7%（6/29）的患者发生围手术期并发症，34.5%（10/29）的患者发生延迟、与血管造影相关的并发症。24.1%（7/29）的患者出现症状性再出血。短期生存（>30 天）为 72.4%（21/29）。中期生存（>90 天）为 37.9%（11/29）。
肝素结合支架移植物治疗大血管损伤是可行的，具有较高的技术成功率。然而，生存率取决于潜在的手术情况，因此需要进行跨学科的患者管理。
支架移植物植入具有挑战性，但技术成功率高。
并发症频繁，但很少需要手术转换。
生存率取决于导致血管损伤的潜在手术情况。
跨学科管理对这些患者的生存至关重要。
