Nana Petroula, Panuccio Giuseppe, Rohlffs Fiona, Torrealba José I, Spanos Konstantinos, Kölbel Tilo
German Aortic Center, Department of Vascular Medicine, University Heart and Vascular Center UKE Hamburg, 20246 Hamburg, Germany.
J Clin Med. 2024 Jun 18;13(12):3578. doi: 10.3390/jcm13123578.
: Among the endovascular approaches for the management of endoleak type 2 (EL 2), transcaval embolization (TCE) has shown encouraging outcomes. However, the literature is still limited. This study aimed to present the early and mid-term outcomes of TCE for EL 2 after endovascular aortic repair. : A retrospective, single-center analysis of consecutive patients managed with TCE for EL 2 after standard or complex endovascular aortic repair, from August 2015 to March 2024, was conducted. The indication for TCE was the presence of an EL 2 related to ≥5 mm sac increase, compared to the first imaging after aneurysm exclusion or the smallest diameter during follow-up. Patients managed with TCE for other types of endoleaks were excluded. The primary outcomes were technical and clinical successes during follow-up. Forty-three patients were included (mean age: 75.1 ± 6.0 years, 90.7% males). Technical success was 97.7%. Selective embolization was performed in 48.8% and non-selective in 51.2%. No death was recorded at 30 days. The estimated clinical success was 90.0% (standard error; SE: 6.7%) and the freedom from EL 2 was 89.0% (SE 6.4%) at 36 months. Cox regression analysis showed that the type of embolization (selective vs. non-selective), type of previous repair (f/bEVAR vs. EVAR), and use of anticoagulants did not affect follow-up outcomes. Reinterventions related to EL 2 were performed in 12.5%; three underwent an open conversion. : TCE was related to high technical success and limited peri-operative morbidity, regardless of the type of initial endovascular aortic repair. Clinical success was encouraging with reinterventions for EL 2 affecting 12.5% of patients.
在用于治疗2型内漏（EL 2）的血管内治疗方法中，经腔静脉栓塞术（TCE）已显示出令人鼓舞的结果。然而，相关文献仍然有限。本研究旨在介绍血管内主动脉修复术后TCE治疗EL 2的早期和中期结果。：对2015年8月至2024年3月期间接受标准或复杂血管内主动脉修复术后因EL 2接受TCE治疗的连续患者进行了一项回顾性单中心分析。TCE的指征是与动脉瘤排除后的首次影像学检查或随访期间的最小直径相比，EL 2相关的囊袋增加≥5 mm。排除因其他类型内漏接受TCE治疗的患者。主要结局是随访期间的技术和临床成功。纳入了43例患者（平均年龄：75.1±6.0岁，男性占90.7%）。技术成功率为97.7%。选择性栓塞占48.8%，非选择性栓塞占51.2%。30天内无死亡记录。36个月时估计临床成功率为90.0%（标准误差；SE：6.7%），无EL 2的比例为89.0%（SE 6.4%）。Cox回归分析表明，栓塞类型（选择性与非选择性）、既往修复类型（f/bEVAR与EVAR）以及抗凝剂的使用均不影响随访结果。与EL 2相关的再次干预率为12.5%；3例接受了开放转换。：无论最初的血管内主动脉修复类型如何，TCE均具有较高的技术成功率和有限的围手术期发病率。临床成功率令人鼓舞，12.5%的患者因EL 2接受了再次干预。
