Ohba Shota, Shimohira Masashi, Hashizume Takuya, Muto Masahiro, Ohta Kengo, Sawada Yusuke, Mizuno Akihiro, Nakai Yosuke, Suda Hisao, Shibamoto Yuta
Department of Radiology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
Department of Radiology, Nagoya Kyoritsu Hospital, Nagoya, Japan.
J Endovasc Ther. 2020 Oct;27(5):828-835. doi: 10.1177/1526602820923954. Epub 2020 May 21.
To evaluate the feasibility and safety of sac embolization with N-butyl cyanoacrylate (NBCA) in emergency endovascular aneurysm repair (EVAR) for ruptured abdominal aortic aneurysm (AAA) and iliac artery aneurysm (IAA) in comparison to EVAR without sac embolization.
Between February 2012 and December 2019, among 44 consecutive patients with ruptured AAA or IAA, 29 underwent EVAR. Of these, 22 patients (median age 77.5 years; 18 men) had concomitant sac embolization using NBCA; the remaining 7 patients (median age 88 years; 6 men) underwent EVAR without sac embolization and form the control group. The technical success, clinical success (hemodynamic stabilization), procedure-related complications, and mortality were compared between the groups.
All EVAR procedures and embolizations were successful. The clinical success rates in the NBCA and control groups were 95% (21/22) and 71% (5/7), respectively (p=0.14). There was no complication related to the procedure. Type II endoleak occurred in 4 of 21 patients (19%) in the NBCA group vs none of the control patients. One patient (5%) died in the NBCA group vs 3 (43%) in the controls (p=0.034).
Sac embolization using NBCA in emergency EVAR appears to be feasible and safe for ruptured AAA and IAA.
评估在急诊血管腔内动脉瘤修复术（EVAR）中，使用氰基丙烯酸正丁酯（NBCA）栓塞瘤腔治疗破裂性腹主动脉瘤（AAA）和髂动脉瘤（IAA）的可行性和安全性，并与未进行瘤腔栓塞的EVAR进行比较。
2012年2月至2019年12月期间，在44例连续性破裂性AAA或IAA患者中，29例接受了EVAR治疗。其中，22例患者（中位年龄77.5岁；18例男性）使用NBCA进行了瘤腔栓塞；其余7例患者（中位年龄88岁；6例男性）未进行瘤腔栓塞，接受了EVAR治疗，作为对照组。比较两组的技术成功率、临床成功率（血流动力学稳定）、手术相关并发症和死亡率。
所有EVAR手术和栓塞均成功。NBCA组和对照组的临床成功率分别为95%（21/22）和71%（5/7）（p=0.14）。未发生与手术相关的并发症。NBCA组21例患者中有4例（19%）发生II型内漏，而对照组无患者发生。NBCA组1例患者（5%）死亡，对照组3例患者（43%）死亡（p=0.034）。
在急诊EVAR中，使用NBCA栓塞瘤腔治疗破裂性AAA和IAA似乎是可行且安全的。
