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采用模块化和一体式腔内移植物对腹主动脉瘤进行选择性血管内修复术。

Elective Endovascular Repair of Abdominal Aortic Aneurysms with Modular and Unibody Type Endografts.

作者信息

Akkaya Bekir Boğaçhan, Ünal Ertekin Utku, Kiriş Erman Sureyya, Özbek Mehmet Hamdi, Civelek İsa, Başar Veysel, Aşkın Göktan, Tütün Ufuk, İşcan Hakkı Zafer

机构信息

Department of Cardiovascular Surgery, Ankara City Hospital, Ankara.

Department of Cardiovascular Surgery, Hakkari State Hospital, Hakkari.

出版信息

Acta Cardiol Sin. 2021 Jul;37(4):386-393. doi: 10.6515/ACS.202107_37(4).20201125A.

Abstract

BACKGROUND

In this study, we aimed to evaluate the performance of modular and unibody endografts for the endovascular repair of abdominal aortic aneurysm (AAA).

METHODS

Between January 2012 and December 2017, 130 elective infrarenal abdominal aortic aneurysms treated in an endovascular manner were retrospectively evaluated. Sixty-six patients with the modular type (Medtronic Endurant II and Lifetech Ankura AAA) and 64 patients with the unibody type (Endologix AFX®) were compared with regards to early and postoperative one-year results.

RESULTS

There was one in-hospital mortality (0.8%) in the modular group. There was no difference in postoperative first-year mortality rate between the two groups (p = 0.678). Loco-regional anesthesia was used more often in the unibody group [34 patients (53.1%)] and the use of general anesthesia was higher in the modular group [56 patients (84.8%)] (p < 0.001). While the duration of the procedure was shorter in the unibody group (p < 0.001), no statistically significant difference was found in the duration of fluoroscopy (p = 0.813) and the amount of contrast agent used (p = 0.553). The follow-up period in the intensive care unit was shorter in the modular group (p < 0.001). Moreover, the five-year survival rate was similar between the groups (84.8% in the modular group and 78.4% in the unibody group, log-rank p = 0.703).

CONCLUSIONS

The results obtained in our study show that modular and unibody grafts are effective and reliable, although there are some negligible differences in the early period.

摘要

背景

在本研究中,我们旨在评估模块化和一体式腔内移植物用于腹主动脉瘤(AAA)血管腔内修复的性能。

方法

回顾性评估2012年1月至2017年12月期间以血管腔内方式治疗的130例择期肾下腹主动脉瘤。比较66例使用模块化移植物(美敦力Endurant II和微创安珂AAA)和64例使用一体式移植物(Endologix AFX®)患者的早期和术后一年结果。

结果

模块化组有1例住院死亡(0.8%)。两组术后第一年死亡率无差异(p = 0.678)。一体式组更常使用局部区域麻醉[34例患者(53.1%)],模块化组全身麻醉的使用率更高[56例患者(84.8%)](p < 0.001)。虽然一体式组手术时间较短(p < 0.001),但在透视时间(p = 0.813)和造影剂用量(p = 0.553)方面未发现统计学显著差异。模块化组在重症监护病房的随访时间较短(p < 0.001)。此外,两组五年生存率相似(模块化组为84.8%,一体式组为78.4%,对数秩检验p = 0.703)。

结论

我们的研究结果表明,模块化和一体式移植物是有效且可靠的,尽管在早期存在一些可忽略不计的差异。

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