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单中心腔内治疗孤立性髂总动脉和髂内动脉瘤合并症的经验

Single-Center Experience in the Endovascular Management of the Combination of Isolated Common and Internal Iliac Artery Aneurysms.

作者信息

Wang Wei, Wu Jianqiang, Shao Jiang, Xu Fang, Chen Yuexin, Liu Bao, Zheng Yuehong

机构信息

Department of Vascular Surgery, State Key Laboratory of Complex Severe and Rare Disease, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

出版信息

Front Surg. 2021 Jul 15;8:693233. doi: 10.3389/fsurg.2021.693233. eCollection 2021.

Abstract

The combination of isolated common and internal iliac artery aneurysms (CIIAA) are rare, life-threatening, abnormal conditions with relatively complex treatment. This study aimed to evaluate the clinical characteristics and treatment outcomes of CIIAA. We retrospectively reviewed 26 patients with CIIAA consecutively treated between January 2010 and August 2020 at Peking Union Medical College Hospital. Demographic, clinical characteristic, treatment strategy and outcome data were collected and analyzed. Twenty-six patients (24 men and 2 women) with a mean age of 70 years were included. There was a total of 72 aneurysms, and the mean diameters of the common iliac artery aneurysms (CIAA) and internal iliac artery aneurysms (IIAA) were 36 and 38 mm, respectively. Ten patients (38%) presented with bilateral CIAA and unilateral IIAA, and eight (31%) had CIAA with ipsilateral IIAA. All patients were treated with endovascular repair, and the overall primary technical success rate was 100%. The surgical techniques mainly included combined bifurcated stent grafting and embolization ( = 11), combined straight stent grafting and embolization ( = 8), and internal iliac artery (IIA) reconstruction ( = 7). There were no patient deaths or reintervention during hospitalization. The mean follow-up time was 43 months, and the patency rate of the stent was 96.2%. The overall reintervention rate was 7.7%. During the follow-up period, there were no aneurysm-related deaths. Endovascular repair involving stent graft placement, coil embolization and IIA revascularization is a safe and effective treatment for isolated CIIAA.

摘要

孤立性髂总动脉和髂内动脉瘤(CIIAA)合并存在的情况较为罕见,危及生命,病情异常且治疗相对复杂。本研究旨在评估CIIAA的临床特征和治疗效果。我们回顾性分析了2010年1月至2020年8月期间在北京协和医院连续接受治疗的26例CIIAA患者。收集并分析了患者的人口统计学、临床特征、治疗策略及预后数据。纳入了26例患者(24例男性和2例女性),平均年龄70岁。共有72个动脉瘤,髂总动脉动脉瘤(CIAA)和髂内动脉动脉瘤(IIAA)的平均直径分别为36 mm和38 mm。10例患者(38%)表现为双侧CIAA和单侧IIAA,8例(31%)为CIAA合并同侧IIAA。所有患者均接受了血管腔内修复治疗,总体主要技术成功率为100%。手术技术主要包括分叉型支架移植物联合栓塞(n = 11)、直型支架移植物联合栓塞(n = 8)以及髂内动脉(IIA)重建(n = 7)。住院期间无患者死亡或再次干预情况。平均随访时间为43个月,支架通畅率为96.2%。总体再次干预率为7.7%。随访期间无动脉瘤相关死亡病例。涉及支架移植物置入、弹簧圈栓塞和IIA血运重建的血管腔内修复术是治疗孤立性CIIAA的一种安全有效的方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/24f7/8319564/326d6a97d1c5/fsurg-08-693233-g0001.jpg

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