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用于股腘动脉瘤修复的Viabahn血管内假体:安全性、成功率和长期通畅率

Viabahn endoprosthesis for femoropopliteal aneurysm repair: safety, success rates, and long-term patency.

作者信息

Brendel Jan M, Mangold Tobias, Pfändler Markus, Stenzl Benedikt, Andic Mateja, Mück Jonas, Schmehl Jörg, Krumm Patrick, Artzner Christoph, Grözinger Gerd, Estler Arne

机构信息

Department of Radiology, Diagnostic and Interventional Radiology, University of Tübingen, Hoppe-Seyler-Straße 3, 72076, Tübingen, Germany.

Department of Anesthesiology and Intensive Care Medicine, Tübingen University Hospital, Tübingen, Germany.

出版信息

CVIR Endovasc. 2024 Jul 8;7(1):53. doi: 10.1186/s42155-024-00465-3.

Abstract

BACKGROUND

The Viabahn endoprosthesis has become a vital option for endovascular therapy, yet there is limited long-term data on its effectiveness for peripheral aneurysm repair. This study aimed to evaluate the safety, technical and clinical success, and long-term patency of the Viabahn endoprosthesis for treating femoropopliteal aneurysms.

METHODS

This retrospective tertiary single-center study analyzed patients who underwent a Viabahn endoprosthesis procedure for femoropopliteal aneurysm repair from 2010 to 2020. Intraoperative complications, technical and clinical success rates, and major adverse events (MAE, including acute thrombotic occlusion, major amputation, myocardial infarction, and device- or procedure-related death) at 30 days were assessed. Incidence of clinically-driven target lesion revascularisation (cdTLR) was noted. Patency rates were evaluated by Kaplan-Meier analysis.

RESULTS

Among 19 patients (mean age, 72 ± 12 years; 18 male, 1 female) who underwent aneurysm repair using the Viabahn endoprosthesis, there were no intraoperative adverse events, with 100% technical and clinical success rates. At the 30-day mark, all patients (19/19, 100%) were free of MAE. The median follow-up duration was 1,009 days [IQR, 462-1,466]. Popliteal stent graft occlusion occurred in 2/19 patients (10.5%) after 27 and 45 months, respectively. Consequently, the primary patency rates were 100%, 90%, 74% at 12, 24, and 36-72 months, respectively. Endovascular cdTLR was successful in both cases, resulting in sustained secondary patency at 100%.

CONCLUSION

The use of Viabahn endoprostheses for femoropopliteal aneurysm repair demonstrated technical and clinical success rates of 100%, a 0% 30-day MAE rate, and excellent long-term patency.

摘要

背景

Viabahn 血管内假体已成为血管内治疗的重要选择,但关于其用于外周动脉瘤修复的长期数据有限。本研究旨在评估 Viabahn 血管内假体治疗股腘动脉瘤的安全性、技术和临床成功率以及长期通畅率。

方法

这项回顾性三级单中心研究分析了 2010 年至 2020 年期间接受 Viabahn 血管内假体治疗股腘动脉瘤的患者。评估术中并发症、技术和临床成功率以及 30 天时的主要不良事件(MAE,包括急性血栓闭塞、大截肢、心肌梗死以及与器械或手术相关的死亡)。记录临床驱动的靶病变血管重建(cdTLR)发生率。通过 Kaplan-Meier 分析评估通畅率。

结果

在 19 例(平均年龄 72±12 岁;18 例男性,1 例女性)接受 Viabahn 血管内假体动脉瘤修复术的患者中,无术中不良事件发生,技术和临床成功率均为 100%。在第 30 天时,所有患者(19/19,100%)均无 MAE。中位随访时间为 1009 天[四分位间距,462 - 1466]。分别在 27 个月和 45 个月后,2/19 例患者(10.5%)发生腘动脉支架移植物闭塞。因此,12 个月、24 个月和 36 - 72 个月时的初级通畅率分别为 100%、90%和 74%。两例患者血管内 cdTLR 均成功,二级通畅率持续保持在 100%。

结论

使用 Viabahn 血管内假体治疗股腘动脉瘤的技术和临床成功率均为 10%0,30 天时 MAE 发生率为 0%,且长期通畅率良好。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aa34/11231120/d13a3f6fce57/42155_2024_465_Fig1_HTML.jpg

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