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肾动脉瘤的自然病史及按时间顺序的生长速率

Natural History and Chronological Growth Rate of Renal Artery Aneurysms.

作者信息

Umetsu Michihisa, Goto Hitoshi, Ohara Masato, Hashimoto Munetaka, Shimizu Takuya, Akamatsu Daijirou, Tsuchida Ken, Tajima Yuta, Suzuki Shunya, Yamamoto Keisuke, Miyagi Shigehito, Unno Michiaki, Kamei Takashi

机构信息

Division of Vascular Surgery, Department of Surgery, Tohoku University, Sendai, Miyagi, Japan.

出版信息

Ann Vasc Dis. 2017 Dec 25;10(4):411-416. doi: 10.3400/avd.oa.17-00075.

Abstract

: Renal artery aneurysm (RAA) is an uncommon disease, the natural course of which is still not well known. The objective of this study is to define factors that affect the growth rate of RAAs. : We retrospectively reviewed 32 aneurysms in 26 patients at our institute between January 2010 and March 2016. Basal demographics, comorbidities, reason for diagnosis, and details of the aneurysms and interventions were recorded. The chronological changes in the diameter of the RAA using multiplanar reconstructions of computed tomography images were measured and analyzed. : The baseline mean diameter was 20.1±8.4 mm (range: 9.9-41). The mean follow-up period was 3.13±2.1 y (range: 0.5-7.1). The median growth rate was 0.35 mm/y (interquartile range: 0.05, 0.62). The growth rate was slower when the initial diameter was <20 mm than when it was >20 mm (p=0.036). Also, whole-completed calcification was a significant factor for slower growth (p=0.016). We performed ex-vivo surgery in two cases and coil packing with stenting in one. No ruptures occurred during the study period. : Our results suggest that cases with an RAA diameter <20 mm do not require intervention. The interval period can be longer in whole-completed calcification types.

摘要

肾动脉动脉瘤(RAA)是一种罕见疾病,其自然病程仍未完全明确。本研究的目的是确定影响肾动脉动脉瘤生长速度的因素。

我们回顾性分析了2010年1月至2016年3月间我院26例患者的32个动脉瘤。记录了患者的基本人口统计学资料、合并症、诊断原因、动脉瘤及干预措施的详细情况。通过计算机断层扫描图像的多平面重建测量并分析肾动脉动脉瘤直径的时间变化。

基线平均直径为20.1±8.4毫米(范围:9.9 - 41毫米)。平均随访时间为3.13±2.1年(范围:0.5 - 7.1年)。中位生长速度为0.35毫米/年(四分位间距:0.05,0.62)。初始直径<20毫米时的生长速度比>20毫米时慢(p = 0.036)。此外,完全钙化是生长较慢的一个重要因素(p = 0.016)。我们对2例患者进行了体外手术,对1例患者进行了带支架的弹簧圈栓塞术。研究期间未发生破裂。

我们的结果表明,肾动脉动脉瘤直径<20毫米的病例无需干预。完全钙化类型的观察间隔期可以更长。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2043/5835437/9d9ce50ab242/avd-10-4-oa.17-00075-figure01.jpg

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