Yazar Ozan, Huysmans Michaël, Lacquet Mathieu, Salemans Pieter B, Wong Chun-Yu, Bouwman Lee H
Department of Vascular and Endovascular Surgery, Zuyderland Medical Center, Heerlen, The Netherlands.
Faculty of Science and Engineering, Maastricht University, Maastricht, The Netherlands.
J Endovasc Ther. 2025 Aug;32(4):1119-1126. doi: 10.1177/15266028231204286. Epub 2023 Oct 16.
To report a single-center result of patients with pararenal aneurysms treated with inner-branched endograft.
This retrospective study analyzed prospectively collected data of patients treated with elective inner-branched endovascular aneurysm repair (iBEVAR) using an Artivion E-xtra custom-made endograft. Primary endpoints were clinical and technical success after iBEVAR. Secondary endpoints were overall survival, target vessel patency during follow-up, aneurysm-related mortality, and freedom from reintervention.
Over a 56-month period, a total of 23 patients (19 men; 72.3±7.2 years) were treated with iBEVAR with a mean follow-up of 15 months. Technical success was achieved in 96% of procedures, incorporating 87 inner branches. Two (8.3%) intraoperative complications (target vessel dissection) were reported, without additional reinterventions needed. Two (8.3%) patients died within 30 days after initial procedure. One due to respiratory failure and the other from an ischemic stroke. During follow-up, 3 patients (13%) required reintervention, either to repair a type I or type III endoleak (n=2) or to place an iliac-branched device, that did not succeed during the initial iBEVAR procedure (n=1). Primary target vessel patency and freedom from reintervention during follow-up was, respectively, 98.9% and 87%. We revealed no aneurysm-related mortality. Overall survival was 78.3%.
The present study confirms previous findings that iBEVAR on the Artivion E-xtra design platform is an effective and safe procedure achieving high technical success rate in the treatment of pararenal abdominal aortic aneurysms.Clinical ImpactInner branched stent-graft configuration combines the benefits of FEVAR and outer-branched stent-graft technology. Implementation of inner branches in stent-grafts is gradually becoming more widespread for the treatment of aneurysms. This report supports the safe and high technical success rate of inner branched stent-grafts in treatment of pararenal abdominal aortic aneurysms.
报告单中心采用内置分支型人工血管治疗肾旁动脉瘤患者的结果。
本回顾性研究分析了前瞻性收集的使用Artivion E-xtra定制人工血管进行选择性内置分支型血管腔内动脉瘤修复术（iBEVAR）患者的数据。主要终点为iBEVAR术后的临床和技术成功率。次要终点为总生存期、随访期间靶血管通畅情况、动脉瘤相关死亡率以及无需再次干预。
在56个月的时间里，共有23例患者（19例男性；年龄72.3±7.2岁）接受了iBEVAR治疗，平均随访15个月。96%的手术获得技术成功，共植入87个内置分支。报告了2例（8.3%）术中并发症（靶血管夹层），无需额外的再次干预。2例（8.3%）患者在初次手术后30天内死亡。1例死于呼吸衰竭，另1例死于缺血性中风。在随访期间，3例患者（13%）需要再次干预，其中2例是为了修复Ⅰ型或Ⅲ型内漏，1例是因为在初次iBEVAR手术期间髂分支装置植入失败而再次植入。随访期间主要靶血管通畅率和无需再次干预率分别为98.9%和87%。未发现动脉瘤相关死亡。总生存率为78.3%。
本研究证实了先前的研究结果，即基于Artivion E-xtra设计平台的iBEVAR是一种有效且安全的手术，在治疗肾旁腹主动脉瘤方面具有较高的技术成功率。临床影响内置分支型支架型人工血管结构结合了腔内修复术（FEVAR）和外置分支型支架型人工血管技术的优点。支架型人工血管中内置分支的应用在动脉瘤治疗中逐渐变得更加广泛。本报告支持内置分支型支架型人工血管在治疗肾旁腹主动脉瘤方面的安全性和高技术成功率。
