Department of Vascular Surgery, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China; Institute of Vascular Diseases, Central South University, Changsha, Hunan, China.
Department of Vascular Surgery, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China; Institute of Vascular Diseases, Central South University, Changsha, Hunan, China; National Center for Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Asian J Surg. 2023 Sep;46(9):3748-3754. doi: 10.1016/j.asjsur.2023.01.052. Epub 2023 Jan 31.
Endovascular abdominal aortic aneurysm repair (EVAR) is the most frequently used treatment for aneurysm in abdominal aorta. The endoleak after EVAR causes the aneurysm sac to remain enlarged and risk for rupture.
The purpose of the study was to assess the efficacy of strategies and techniques for endoleak treatment.
This study was a single center retrospective study of 30 patients who had kinds of endoleak. The 30 patients were from a cohort of 597 patients who received EVAR from the Secondary Xiangya Hospital, Central South University between Jan 2014 to Dec 2021, what is follow-up well and diagnosed as endoleak. Data included basic clinical information, aspects of the endoleak treatment techniques, and follow-up findings.
The 30 patients with endoleak were diagnosed by computed tomography angiography or digital subtraction angiography. Age is 69 ± 7.9 yrs. 26 patients are male with only 4 female patients. Immediate endoleak after EVAR is 46.7%and delayed endoleak is 53.3%. The classification of endoleak is type Ⅰ:76.6%; type Ⅱ 26.7%; type Ⅲ:6.7%; type Ⅳ:6.7%; type Ⅴ:13.3%. Different treatment of endoleak includes: screening, endovascular re-intervention and open surgery. There are 3 patients (10.0%) underwent emergency EVAR due to their rupture condition of aneurysm. All the endoleak patients' CTA image characteristics has been reviewed. The follow-up rate is 93.3%. There are 6 patients (21.4%) died during follow-up. No aneurysm sac rupture death has been recorded.
Endoleak after EVAR is the most frequent complication that directly affects survival and re-intervention rates. Our findings suggested that different treatment strategies based on the individual patient's situation is important for their endoleak treating result.
血管内腹主动脉瘤修复术（EVAR）是治疗腹主动脉瘤最常用的方法。EVAR 后的内漏会导致动脉瘤囊持续增大并增加破裂风险。
本研究旨在评估内漏治疗策略和技术的疗效。
这是一项单中心回顾性研究，纳入了 30 名患有各种内漏的患者。这 30 名患者来自中南大学湘雅二医院 2014 年 1 月至 2021 年 12 月期间接受 EVAR 的 597 名患者队列，这些患者随访情况良好且被诊断为内漏。数据包括基本临床信息、内漏治疗技术方面以及随访结果。
30 名内漏患者通过计算机断层血管造影或数字减影血管造影确诊。患者年龄为 69 ± 7.9 岁，其中 26 名男性，4 名女性。EVAR 后即刻内漏发生率为 46.7%，迟发性内漏发生率为 53.3%。内漏的分类为：Ⅰ型：76.6%；Ⅱ型：26.7%；Ⅲ型：6.7%；Ⅳ型：6.7%；Ⅴ型：13.3%。不同的内漏治疗方法包括：筛查、血管内再次介入和开放手术。有 3 名患者（10.0%）因动脉瘤破裂而紧急行 EVAR。所有内漏患者的 CTA 图像特征均已进行了回顾，随访率为 93.3%。随访期间有 6 名患者（21.4%）死亡，无动脉瘤破裂死亡记录。
EVAR 后的内漏是最常见的并发症，直接影响患者的生存率和再次干预率。我们的研究结果表明，基于患者个体情况的不同治疗策略对内漏的治疗结果非常重要。
