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腹主动脉瘤的血管内解决方案:定制内支架的临床结果比较综述。

Endovascular solutions for abdominal aortic aneurysms: A comparative review of clinical outcomes with custom-made endografts.

机构信息

Hull York Medical School, University of York, York, UK.

East Lancashire Teaching Hospitals NHS Trust, Blackburn, UK.

出版信息

Asian Cardiovasc Thorac Ann. 2023 Sep;31(7):565-576. doi: 10.1177/02184923221133956. Epub 2022 Oct 26.

Abstract

BACKGROUND

The introduction of endovascular aortic repair has revolutionised the treatment of abdominal aortic aneurysms, replacing open surgical repair for the majority of elective cases due to its optimal morbidity and mortality. Several endovascular aortic repair stent grafts exist commercially, one of which is the Fenestrated Anaconda™ by Terumo Aortic which benefits from a very innovative design, unique custom-made approach and highly favourable results.

AIMS

The main scope of this narrative review is to provide a comprehensive overview of endovascular aortic repair clinical outcomes using the Fenestrated Anaconda™ stent-graft and comparing these with its market competitor, Zenith. This review will also examine the evidence in the literature on the Anaconda™'s custom-made approach.

METHODS

A comprehensive literature was conducted on several search engines including PubMed, Google Scholar, Ovid, Scopus and Embase to collate the evidence in the literature on clinical outcomes achieved with the Fenestrated Anaconda™ and Zenith including, but not limited to, survival, technical success, target vessel patency, endoleak, reintervention and aneurysm sac regression.

RESULTS

The Fenestrated Anaconda™ is associated with excellent results, including highly favourable survival, technical and clinical success and target vessel patency rates, very low need for reintervention or conversion, and minimal incidence of complications such as endoleak and endograft migration. The Fenestrated Anaconda™ also drives significant sac regression and aortic remodelling. In addition, its unique custom-made approach enables it to treat highly complex aortic anatomy as well as to 'rescue' failed competitor grafts.

CONCLUSION

The Fenestrated Anaconda™ has proven that it is a very safe, highly applicable and extremely effective device used for complex aortic and/or iliac pathology based on its novel design and outstanding track record of clinical outcomes.

摘要

背景

腔内血管修复术的引入彻底改变了腹主动脉瘤的治疗方式,由于其较低的发病率和死亡率,大多数择期病例已不再采用开放手术修复,转而采用腔内血管修复术。目前市场上存在几种腔内血管修复术用主动脉支架移植物,其中一种是由 Terumo Aortic 生产的 Fenestrated Anaconda™,它具有创新性的设计、独特的定制方法和非常有利的结果。

目的

本叙述性文献综述的主要目的是全面概述 Fenestrated Anaconda™支架移植物的血管内修复治疗的临床结果,并将其与市场竞争对手 Zenith 进行比较。本综述还将研究文献中关于 Anaconda™定制方法的证据。

方法

在包括 PubMed、Google Scholar、Ovid、Scopus 和 Embase 在内的多个搜索引擎上进行了全面的文献检索,以收集 Fenestrated Anaconda™和 Zenith 在临床结果方面的文献证据,包括但不限于生存率、技术成功率、靶血管通畅率、内漏、再次干预和动脉瘤囊缩小。

结果

Fenestrated Anaconda™的结果非常出色,包括极高的生存率、技术和临床成功率以及靶血管通畅率,再干预或转换的需求极低,并发症发生率如内漏和移植物迁移极低。 Fenestrated Anaconda™还可显著缩小瘤囊并重塑主动脉。此外,其独特的定制方法使其能够治疗复杂的主动脉解剖结构,还可以“挽救”失败的竞争对手移植物。

结论

Fenestrated Anaconda™通过其新颖的设计和出色的临床结果记录,已被证明是一种非常安全、高度适用且极其有效的治疗复杂主动脉和/或髂动脉病变的设备。

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