Najafi Arash, Sheikh Gabriel Tobias, Wigger Pius, Binkert Christoph A
Department of Radiology and Nuclear Medicine, Canton Hospital Winterthur, 8401, Winterthur, Switzerland.
Department of Vascular Surgery, Canton Hospital Winterthur, 8401, Winterthur, Switzerland.
CVIR Endovasc. 2019 Apr 23;2(1):13. doi: 10.1186/s42155-019-0058-0.
Endovascular aortic sealing (EVAS) using the Nellix system was a new approach to reduce the frequency of type II endoleaks after endovascular aortic repair. We analyzed the mid-term results, specifically looking at device migration, endoleaks and subsequent necessary secondary interventions.
Ten patients underwent elective EVAS treatment during our study period. 7 patients were within the IFU while 3 patients had a proximal neck shorter than 10 mm. Technical success rate was 100% and there were no short-term vascular complications. One patient died from urosepsis 14 days after the procedure and was excluded from further analysis. A total of 6 out of 9 patients (67%) experienced device complications such as proximal graft kinking, limb separation or caudal migration. 5 also showed type Ia endoleak.
While no complication occurred short-term (up to 12 months), the Nellix system showed a high percentage of limb separation, caudal graft migration, and type Ia endoleak on mid-term follow-up, likely due to insufficient proximal anchoring of the device. Possible salvage treatments are discussed.
使用Nellix系统进行血管腔内主动脉封闭术(EVAS)是一种降低血管腔内主动脉修复术后II型内漏发生率的新方法。我们分析了中期结果,特别关注装置移位、内漏以及随后必要的二次干预情况。
在我们的研究期间,10例患者接受了择期EVAS治疗。7例患者符合使用说明,3例患者近端颈部短于10毫米。技术成功率为100%,且无短期血管并发症。1例患者在术后14天死于尿脓毒症,被排除在进一步分析之外。9例患者中有6例(67%)出现了装置并发症,如近端移植物扭结、肢体分离或尾端移位。5例还出现了Ia型内漏。
虽然短期内(长达12个月)未发生并发症,但Nellix系统在中期随访中显示出较高比例的肢体分离、尾端移植物移位和Ia型内漏,这可能是由于该装置近端锚定不足所致。文中讨论了可能的挽救治疗方法。