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Jotec E-Ventus BX覆膜支架在腔内修复腹主动脉瘤和髂支装置中的应用:单中心经验

Jotec E-Ventus BX Stent Graft Deployment in the FEVAR and Iliac Branch Device: Single Centre Experience.

作者信息

Sayed Tamer, Ahmed Islam, Rodway Alexander, El Sakka Karim, Yusuf Syed Waquar

机构信息

Vascular and Endovascular Surgery Department, Brighton and Sussex University Hospitals NHS Trust, Brighton, UK.

出版信息

Ann Vasc Dis. 2019 Jun 25;12(2):171-175. doi: 10.3400/avd.oa.18-00101.

Abstract

: To evaluate the outcomes of the E-ventus BX balloon-expandable stent graft system (Jotec, Hechingen, Germany) implanted as bridging stent grafts during fenestrated endovascular aortic repair (FEVAR) and the iliac branch device (IBD) of complex aneurysms. : This was a single centre retrospective analysis prospective study including all consecutive patients treated by FEVAR and the IBD performed with E-ventus BX stent grafts as bridging stents. Demographics of patients, the diameter and length of the bridging stent grafts, technical success, reinterventions, occlusions, post-operative events, and imaging (computed tomography [CT] scan and ultrasound) were prospectively collected in an electronic database. Follow-ups were performed with clinical assessment and a CT angiogram scan at four weeks after discharge followed by a duplex ultrasound every six months for two years and then a yearly duplex scan afterwards. : Between June 2015 and October 2017, 40 consecutive patients (three females) were treated with custom made fenestrated endografts and the iliac branch device for complex aneurysms, using the E-Ventus BX stent graft. All 82 E-Ventus BX stent grafts were successfully delivered and deployed. There was no in-hospital mortality. The early bridging stents patency rate was 97.6% (80 out of 82). The two-target vessel post-operative occlusion was secondary to kink of the renal stents and failure for re-lining of the renal artery. Of the two patients, only one needed permanent dialysis. On the late follow-up (after 30 days), two other patients demonstrated a renal stent occlusion, with one treated successfully with re-lining of the stent and the other patient treated conservatively. Neither of them needed permanent dialysis. A follow-up was maintained for 36 patients until April 2018 with a median follow-up of 18 months. All bridging stents E-Ventus BX stent grafts remained patent (78 out of 82, 95.1%). : E-Ventus BX stent grafts used as bridging stents during FEVAR and the IBD are associated with favourable outcomes at the mid-term follow-up. Long-term follow-up is required to confirm these promising results.

摘要

评估在开窗式血管腔内主动脉修复术(FEVAR)期间作为桥接支架植入的E-ventus BX球囊扩张式覆膜支架系统(德国黑兴根Jotec公司)以及复杂动脉瘤的髂支装置(IBD)的治疗效果。:这是一项单中心回顾性分析前瞻性研究,纳入了所有接受FEVAR治疗且使用E-ventus BX覆膜支架作为桥接支架进行IBD治疗的连续患者。前瞻性地在电子数据库中收集患者的人口统计学数据、桥接覆膜支架的直径和长度、技术成功率、再次干预情况、闭塞情况、术后事件以及影像学检查(计算机断层扫描[CT]和超声)结果。出院后四周进行临床评估和CT血管造影扫描进行随访,随后两年内每六个月进行一次双功超声检查,之后每年进行一次双功超声扫描。:2015年6月至2017年10月期间,连续40例患者(3例女性)使用E-Ventus BX覆膜支架接受定制开窗式腔内移植物和髂支装置治疗复杂动脉瘤。所有82个E-Ventus BX覆膜支架均成功输送并展开。无院内死亡病例。早期桥接支架通畅率为97.6%(82个中的80个)。两个目标血管术后闭塞是由于肾支架扭结和肾动脉重新内衬失败所致。在这两名患者中,只有一名需要长期透析。在晚期随访(30天后),另外两名患者出现肾支架闭塞,其中一名通过支架重新内衬成功治疗,另一名患者接受保守治疗。他们两人均不需要长期透析。对36例患者进行随访至2018年4月,中位随访时间为18个月。所有桥接支架E-Ventus BX覆膜支架均保持通畅(82个中的78个,95.1%)。:在FEVAR和IBD期间用作桥接支架的E-Ventus BX覆膜支架在中期随访中具有良好的治疗效果。需要长期随访以证实这些有前景的结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1cb8/6600105/b6eebe67fa95/avd-12-2-oa.18-00101-figure01.jpg

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