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孤立性髂动脉瘤血管腔内修复的技术问题与临床结果:单中心经验

Technical issues and clinical outcomes of endovascular repair of isolated iliac artery aneurysms: A single-center experience.

作者信息

Gao Peixian, Dong Dianning, Yang Le, Yuan Hai, Wang Mo, Zhang Jingyong, Zhong Zhenyue, Zhang Shiyi, Jin Xing, Wu Xuejun

机构信息

Department of Vascular Surgery, Shandong Provincial Hospital Affiliated to Shandong University, Ji'nan, Shandong, China.

出版信息

Vascular. 2018 Dec;26(6):591-599. doi: 10.1177/1708538118776854. Epub 2018 Jun 4.

Abstract

PURPOSE

Isolated iliac artery aneurysms are the relatively uncommon condition. This study aims to evaluate the technical issues and clinical outcomes of endovascular repair in a cohort of isolated iliac artery aneurysms treated.

METHODS

We retrospectively reviewed 22 consecutive patients with isolated iliac artery aneurysms between December 2006 and September 2016. Iliac artery aneurysms were treated in one of the three ways: (1) standard bifurcated aortic stent graft placement with limb extension; (2) coverage of iliac artery aneurysms with covered stent grafts; and (3) embolization of the arterial branches distal to the aneurysms with coils or vascular plugs.

RESULTS

Twenty-two patients (20 men) with a mean age 64.7 years underwent endovascular repair during the study period. The median diameter of the isolated iliac artery aneurysms was 5.9 ± 1.7 cm (2.9-9.0 cm). Technical success was 95.5%. Conversion to open surgery was performed in one patient with bilateral internal iliac artery aneurysms. Four patients underwent placement of a bifurcated stent graft. A covered stent graft was deployed in 16 patients, with embolization of internal iliac artery in 14 patients. Simple coil embolization of isolated internal iliac artery aneurysm was performed in one patient. There was one sudden cardiac death on day 4 after the procedure due to heart failure. During the follow-up period (range: 1-50 months, mean 19.8 months), five patients died of causes not related to isolated iliac artery aneurysms, and transient buttock claudication was observed in one patient.

CONCLUSIONS

Our study documents the safety and effectiveness of endovascular repair of isolated iliac artery aneurysms with low morbidity and mortality.

摘要

目的

孤立性髂动脉瘤是一种相对罕见的疾病。本研究旨在评估一组接受治疗的孤立性髂动脉瘤患者进行血管腔内修复的技术问题及临床疗效。

方法

我们回顾性分析了2006年12月至2016年9月期间连续收治的22例孤立性髂动脉瘤患者。髂动脉瘤采用以下三种方法之一进行治疗:(1)标准分叉型主动脉覆膜支架置入并延长分支;(2)用覆膜支架覆盖髂动脉瘤;(3)用弹簧圈或血管塞栓塞动脉瘤远端的动脉分支。

结果

研究期间,22例患者(20例男性)平均年龄64.7岁接受了血管腔内修复。孤立性髂动脉瘤的中位直径为5.9±1.7 cm(2.9 - 9.0 cm)。技术成功率为95.5%。1例双侧髂内动脉瘤患者转为开放手术。4例患者置入了分叉型支架移植物。16例患者置入了覆膜支架,其中14例患者栓塞了髂内动脉。1例患者对孤立性髂内动脉瘤进行了单纯弹簧圈栓塞。术后第4天有1例因心力衰竭突然心脏死亡。随访期间(范围:1 - 50个月,平均19.8个月),5例患者死于与孤立性髂动脉瘤无关的原因,1例患者出现短暂性臀部间歇性跛行。

结论

我们的研究证明了孤立性髂动脉瘤血管腔内修复的安全性和有效性,其发病率和死亡率较低。

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