Janho Kristi E, Rashaideh Mohammed A, Shishani Jan, Jalokh Muhannad, Haboub Hazem
Vascular Surgery Department, King Hussin Medical Center at Royal Medical Services, Amman, Jordan.
Interventional Radiology Department, King Hussin Medical Center at Royal Medical Services, Amman, Jordan.
Vasc Specialist Int. 2019 Dec;35(4):202-208. doi: 10.5758/vsi.2019.35.4.202. Epub 2019 Dec 31.
The outcomes of endovascular aneurysmal repair (EVAR) for infrarenal abdominal aortic aneurysms (AAAs) in the Middle East have rarely been reported. We analyzed the outcomes of EVAR in a Jordanian population.
We conducted a retrospective review of the medical records of patients with infrarenal AAA who were treated with elective EVAR between January 2004 and January 2017 at a single center in Jordan. Patient characteristics, anatomical characteristics, procedural details, and early and late postoperative outcomes were analyzed.
A total of 288 patients (mean age, 70 years; 77.8% males) underwent EVAR for infrarenal AAA (median aneurysm size, 64 mm). Bifurcated endografts were used in 265 patients, and aorto-uni-iliac devices were used in 22 patients. Successful endograft deployment was achieved in all patients with no open conversion. Early complications included localized groin hematoma in 15, femoral artery dissection in 4, wound infection in 3, and seroma in 3 patients. With a mean follow-up of 60 months, 50 endoleaks were detected, including 9 type I, 38 type II, and 3 type III. Seven patients had unilateral graft limb occlusion. The 30-day mortality was 1.7%, and long-term mortality was 7.0%, mostly due to non-AAA-related causes.
EVAR was safely performed in Jordanian patients with minimal complications. However, long-term surveillance is important due to the risk of endoleaks and consequent intervention.
中东地区肾下腹主动脉瘤(AAA)的血管内动脉瘤修复术(EVAR)的结果鲜有报道。我们分析了约旦人群中EVAR的结果。
我们对2004年1月至2017年1月期间在约旦一家单一中心接受择期EVAR治疗的肾下AAA患者的病历进行了回顾性研究。分析了患者特征、解剖特征、手术细节以及术后早期和晚期结果。
共有288例患者(平均年龄70岁;77.8%为男性)接受了肾下AAA的EVAR治疗(动脉瘤大小中位数为64mm)。265例患者使用了分叉型血管内移植物,22例患者使用了主动脉单髂动脉装置。所有患者均成功植入血管内移植物,无一例转为开放手术。早期并发症包括15例局部腹股沟血肿、4例股动脉夹层、3例伤口感染和3例血清肿。平均随访60个月,检测到50例内漏,包括9例I型、38例II型和3例III型。7例患者出现单侧移植物肢体闭塞。30天死亡率为1.7%,长期死亡率为7.0%,主要是由于非AAA相关原因。
约旦患者安全地接受了EVAR治疗,并发症极少。然而,由于存在内漏风险及随之而来的干预,长期监测很重要。