腹主动脉瘤腔内修复术前积极进行动脉瘤囊栓塞在预防Ⅱ型内漏和瘤囊扩张中的作用
Role of Aggressive Aneurysm Sac Embolization Before Endovascular Abdominal Aneurysm Repair in Preventing Type II Endoleak and Sac Expansion.
作者信息
Yoshikawa Yasushi, Kishimoto Satoru, Takasugi Shohei, Kishimoto Yuichiro, Onohara Takeshi, Kumagai Kunitaka, Nii Rikuto, Kishimoto Nozomi, Yoshikawa Yuki, Yata Shinsaku, Fujii Shinya, Nishimura Motonobu
机构信息
Division of Cardiovascular Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8503, Japan and.
Department of Radiology, School of medicine, Faculty of Medicine, Tottori University, Yonago 683-8503, Japan.
出版信息
Yonago Acta Med. 2023 Apr 26;66(2):232-238. doi: 10.33160/yam.2023.05.010. eCollection 2023 May.
BACKGROUND
This study aimed to evaluate the effect of aggressive embolization of side branches arising from the aneurysmal sac before endovascular aneurysm repair.
METHODS
This retrospective study included 95 patients who underwent endovascular infrarenal abdominal aortic aneurysm repair at Tottori University Hospital between October 2016 and January 2021. Of these, 54 underwent standard endovascular aneurysm repair (conventional group), and 41 underwent coiling of the inferior mesenteric and lumbar arteries before undergoing endovascular aneurysm repair (embolization group). The occurrence of type II endoleak, change in aneurysmal sac diameter, and reintervention rate due to type II endoleak during follow-up were evaluated.
RESULTS
Compared to the conventional group, the embolization group had a significantly lower incidence of type II endoleak, more frequent aneurysmal sac shrinkage, and lower aneurysmal sac growth related to type II endoleak.
CONCLUSION
Our results demonstrated the effectiveness of aggressive aneurysmal sac embolization before endovascular aneurysm repair to prevent type II endoleak and the consequent long-term aneurysmal sac enlargement.
背景
本研究旨在评估在血管内动脉瘤修复术前对动脉瘤囊发出的侧支进行积极栓塞的效果。
方法
这项回顾性研究纳入了2016年10月至2021年1月期间在鸟取大学医院接受血管内肾下腹主动脉瘤修复术的95例患者。其中，54例接受了标准血管内动脉瘤修复术（传统组），41例在接受血管内动脉瘤修复术前对肠系膜下动脉和腰动脉进行了弹簧圈栓塞（栓塞组）。评估随访期间II型内漏的发生情况、动脉瘤囊直径的变化以及因II型内漏导致的再次干预率。
结果
与传统组相比，栓塞组II型内漏的发生率显著更低，动脉瘤囊缩小更频繁，且与II型内漏相关的动脉瘤囊生长更低。
结论
我们的结果表明，在血管内动脉瘤修复术前对动脉瘤囊进行积极栓塞可有效预防II型内漏及随之而来的动脉瘤囊长期扩大。
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