Clinic of Vascular and Endovascular Surgery, University of Münster, Albert-Schweitzer Campus 1, 48145 Muenster, Germany.
Clinic of Vascular and Endovascular Surgery, University of Münster, Albert-Schweitzer Campus 1, 48145 Muenster, Germany.
J Vasc Interv Radiol. 2019 Apr;30(4):531-538. doi: 10.1016/j.jvir.2018.11.028. Epub 2019 Mar 15.
To evaluate the effectiveness and durability of intra-arterial aneurysm sac embolization for the treatment of type Ia endoleak after endovascular aneurysm repair (EVAR).
From February 2011 to December 2016, 22 patients underwent embolization of a type Ia endoleak after EVAR. Four patients (18%) were treated during the index EVAR and 18 (82%) in follow-up. Five patients (23%) were treated urgently and 17 (77%) electively. The embolization was performed with the use of liquid embolic agent, coils, and/or plugs. Adjunctive neck procedures were performed in 55% (n = 12) of the patients. The primary endpoint of this study was freedom from sac enlargement. Key secondary endpoints were technical success and freedom from endoleak-related reinterventions.
Technical success was 100%. The 30-day mortality was 5% (n = 1; acute coronary syndrome). At a mean follow-up of 15.4 months (range 0.1-65.4) the freedom from sac enlargement rate was 76% (16 out of 21). Reintervention-free survival rates at 6, 12, and 24 months were 80%, 68% and 68%, respectively.
In patients with persistent type Ia endoleak the embolization of the aneurysm sac with or without adjunctive neck procedures can be safely performed, leading to acceptable clinical and radiologic outcomes.
评估血管内动脉瘤修复术（EVAR）后腔内治疗 I 型内漏的疗效和持久性。
2011 年 2 月至 2016 年 12 月，22 例患者接受了 EVAR 后 I 型内漏的栓塞治疗。4 例（18%）在指数 EVAR 期间治疗，18 例（82%）在随访中治疗。5 例（23%）为紧急治疗，17 例（77%）为择期治疗。栓塞采用液体栓塞剂、线圈和/或塞子进行。55%（n=12）的患者行附加颈部手术。本研究的主要终点是无瘤腔扩大。主要次要终点是技术成功和无内漏相关再干预。
技术成功率为 100%。30 天死亡率为 5%（n=1；急性冠状动脉综合征）。平均随访 15.4 个月（0.1-65.4），瘤腔无扩大率为 76%（21 例中有 16 例）。6、12 和 24 个月的无再干预生存率分别为 80%、68%和 68%。
对于持续性 I 型内漏患者，瘤腔栓塞联合或不联合附加颈部手术可安全进行，可获得可接受的临床和影像学结果。
