Department of Vascular Surgery, Affiliated Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China.
Department of Otolaryngology Head and Neck Surgery, Affiliated Drum Tower Hospital, Medical School of Nanjing University, Jiangsu Provincial Key Medical Discipline (Laboratory), Nanjing, China.
J Endovasc Ther. 2024 Dec;31(6):1150-1157. doi: 10.1177/15266028231165185. Epub 2023 Apr 17.
To report the method and curative effect of using a physician modified Y-type iliac branch device (PMYIBD) to preserve the internal iliac artery during the endovascular repair of abdominal aortic aneurysms.
From September 2018 to April 2022, 24 patients with abdominal aortic aneurysms or dissecting aneurysms, including 19 true aneurysms and 5 dissecting aneurysms involving the common iliac artery were treated in our department. The average age was (65.3 ± 7.6) years. All patients underwent preoperative evaluation by enhanced computed tomography. Combined with intraoperative angiography, a Y-type stent graft was prepared during surgery to perform endovascular repair of abdominal aortic aneurysms.
All operations were successfully completed. The average operative duration was (224.8 ± 44.1) minutes. A total of 24 internal iliac arteries were reconstructed. The average follow-up time was (27.1 ± 13.5) months. During the follow-up, there was no expansion of aneurysm cavity, no endoleak or stent displacement, and no death occurred in all patients.
The physician-modified Y-type iliac branched device (PMYIBD) provides an effective method for full-cavity repair. It has a wide range of indications and convenience. According to follow-up results, the early and mid-term had good curative effects; however, the long-term effects require further follow-up.
The modified Y-type IBD technique is safe and effective for aortic diseases involving internal iliac artery especially with complex anatomy.
It is meaningful to preserve the IIA during EVAR. The use of PMYIBD provides a simple and effective method for the total endovascular repair of aortic diseases involving the IIA. Several advantages such as minimal trauma, low mortality, low complication rates and perfect short- and medium-term effects emerge in clinical practice. PMYIBDs are good choices for clinicians before suitable commercial stents are available in markets.
报告一种使用改良的医师型 Y 型髂内分支装置（PMYIBD）在腹主动脉瘤腔内修复术中保留髂内动脉的方法和疗效。
自 2018 年 9 月至 2022 年 4 月，我科收治腹主动脉瘤或夹层动脉瘤患者 24 例，其中真性动脉瘤 19 例，累及髂总动脉夹层动脉瘤 5 例。平均年龄（65.3±7.6）岁。所有患者均行增强 CT 术前评估。结合术中血管造影，术中制备 Y 型支架移植物，行腹主动脉瘤腔内修复术。
所有手术均顺利完成。手术平均时间（224.8±44.1）分钟。共重建 24 条髂内动脉。平均随访时间（27.1±13.5）个月。随访期间，所有患者均无瘤腔扩大、内漏或支架移位，无死亡。
医师改良的 Y 型髂内分支装置（PMYIBD）为全腔修复提供了一种有效的方法，适应证广泛，操作方便。根据随访结果，早期和中期疗效良好，但长期效果需要进一步随访。
改良的 Y 型 IBD 技术对于涉及髂内动脉的主动脉疾病，尤其是复杂解剖结构的主动脉疾病，是安全有效的。
在 EVAR 中保留 IIA 是有意义的。PMYIBD 的使用为涉及 IIA 的主动脉疾病的全腔内修复提供了一种简单有效的方法。在临床实践中具有创伤小、死亡率低、并发症发生率低、短期和中期效果完美等优点。在合适的商用支架上市之前，PMYIBD 是临床医生的良好选择。
