Ma Tianfeng, He Yangyan, Zhong Wen, Luo Geng, Li Qiang, Wang Zhize, Zhang Hongkun, Wu Ziheng, Qiu Chenyang
Department of Vascular Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.
Department of Clinical Pharmacy, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.
Ann Vasc Surg. 2021 May;73:296-302. doi: 10.1016/j.avsg.2020.11.044. Epub 2020 Dec 30.
Coil embolization (CE) alone and stent-assisted coil embolization (SCE) are two major endovascular techniques to treat renal artery aneurysms (RAAs). This study aimed at providing safety and efficacy data of CE and SCE for RAAs.
Between August 2015 and June 2019, 40 RAA patients treated with CE or SCE were included in the retrospective study. Patients' demographics, clinical manifestations, aneurysm characteristics, treatment strategies, and follow-up results were collected and analyzed.
There were 26 and 14 patients in the CE and SCE group, respectively. The mean aneurysm diameter was 2.5 ± 1.5 cm and 2.2 ± 0.8 cm (CE versus SCE, P = 0.52). The neck width of the aneurysm was 0.63 ± 0.37 cm and 1.07 ± 0.42 cm (CE versus SCE, P = 0.021). Technical success was achieved in 97.5% patients. No death or aneurysm rupture occurred. During the perioperative period, 12% and 7.1% patients suffered partial renal infarction (CE versus SCE, P = 0.45). The mean duration of follow-up was 8.8 ± 9.4 months and 16.1 ± 16.3 months (CE versus SCE, P = 0.158) by imaging and 20.8 ± 11.3 and 22.7 ± 16.5 months by visit/telephone (CE versus SCE, P = 0.703). During the follow-up, 17.4% patients in the CE group and 30.8% patients in the SCE group suffered partial renal infarction, while their overall renal function remained normal. In addition, there was no aneurysm recurrence, sac enlargement, or death in both groups.
Both CE and SCE were safe and effective to treat RAAs. In addition, SCE may prevent coil migration in the wide neck aneurysm in selected patients.
单纯弹簧圈栓塞术(CE)和支架辅助弹簧圈栓塞术(SCE)是治疗肾动脉动脉瘤(RAA)的两种主要血管内技术。本研究旨在提供CE和SCE治疗RAA的安全性和有效性数据。
2015年8月至2019年6月,40例接受CE或SCE治疗的RAA患者纳入回顾性研究。收集并分析患者的人口统计学资料、临床表现、动脉瘤特征、治疗策略及随访结果。
CE组和SCE组分别有26例和14例患者。动脉瘤平均直径分别为2.5±1.5 cm和2.2±0.8 cm(CE组与SCE组,P = 0.52)。动脉瘤颈部宽度分别为0.63±0.37 cm和1.07±0.42 cm(CE组与SCE组,P = 0.021)。97.5%的患者技术成功。无死亡或动脉瘤破裂发生。围手术期,12%和7.1%的患者发生部分肾梗死(CE组与SCE组,P = 0.45)。影像学随访平均时间分别为8.8±9.4个月和16.1±16.3个月(CE组与SCE组,P = 0.158),门诊/电话随访平均时间分别为20.8±11.3个月和22.7±16.5个月(CE组与SCE组,P = 0.703)。随访期间,CE组17.4%的患者和SCE组30.8%的患者发生部分肾梗死,但其总体肾功能仍正常。此外,两组均无动脉瘤复发、瘤囊增大或死亡。
CE和SCE治疗RAA均安全有效。此外,SCE可能预防部分患者宽颈动脉瘤内弹簧圈移位。