St Georges Hospital NHS Foundation Trust, Blackshaw Road, Tooting, London, UK.
Cardiovasc Intervent Radiol. 2023 Apr;46(4):428-435. doi: 10.1007/s00270-022-03342-5. Epub 2023 Jan 27.
To describe the long-term outcomes following transarterial embolisation for type Ia endoleaks (ELIa) in patients who failed or were unsuitable for standard endovascular/surgical options.
A retrospective single-centre observational study was performed between October 2010 and April 2018. Technical success rates and long-term outcomes were evaluated. A sub-analysis was performed comparing outcomes of covered aortic endografts and Nellix endovascular aneurysm sealing systems.
A total of 34 transcatheter embolisations were performed for ELIa in 27 patients (13 endografts and 14 patients with Nellix systems). A combination of Onyx and coils was used most frequently (18/34), followed by Onyx alone (14/34) and coils alone (2/34). Technical success was achieved in 33/34 (97%) procedures . Seven early complications occurred with no immediate mortality, 5 of which involved migration/reflux of embolic into the endograft-all successfully managed via endovascular approach. Following the surveillance period (mean 25 months), 13/26 (50%) of patients were free from recurrent endoleak. Sac expansion occurred in 42% (11/26). 21/26 patients died; 6 due to aneurysm sac rupture, 10 due to unrelated causes, and 5 had no cause of death available. No significant difference in survival was found between patients with an endograft or Nellix graft-Chi-squared value - 0.011 (p < 0.05 = 3.84).
Transcatheter embolisation for type Ia endoleaks is a safe and effective option in a select patient cohort-where traditional endovascular and surgical options are unsuitable or have failed. The procedure may prevent recurrence in some whilst delaying rupture and death in others.
描述在标准血管内/手术治疗选择失败或不适用的情况下，接受经动脉栓塞治疗 I 型内漏（ELIa）患者的长期结果。
回顾性单中心观察研究于 2010 年 10 月至 2018 年 4 月进行。评估了技术成功率和长期结果。进行了一项亚分析，比较了带覆盖的主动脉内覆膜支架和 Nellix 血管内动脉瘤密封系统的结果。
在 27 名患者（13 名带覆膜支架和 14 名使用 Nellix 系统的患者）中，共进行了 34 次经导管栓塞治疗 ELIa。最常使用的是 Onyx 和线圈的组合（18/34），其次是单独使用 Onyx（14/34）和单独使用线圈（2/34）。33/34 例（97%）手术达到技术成功。7 例早期并发症发生，无即时死亡，其中 5 例涉及栓塞物向覆膜支架内迁移/反流，均通过血管内方法成功处理。在随访期间（平均 25 个月），26 名患者中有 13 名（50%）无复发性内漏。囊腔扩张发生率为 42%（11/26）。26 名患者中有 21 名死亡；6 例死于动脉瘤囊破裂，10 例死于非相关原因，5 例死因不详。带覆膜支架或 Nellix 支架的患者生存无显著差异-卡方值-0.011（p<0.05=3.84）。
在传统血管内和手术治疗选择不适用或失败的情况下，经导管栓塞治疗 I 型内漏是一种安全有效的选择。该治疗可能在某些情况下预防复发，而在其他情况下延迟破裂和死亡。
