Talaie Reza, Torkian Pooya, Spano Anthony, Mahjoubnia Alireza, Flanagan Siobhan M, Rosenberg Michael, Lin Jian, Golzarian Jafar, Shrestha Preshant
Vascular and Interventional Radiology, Department of Radiology, University of Minnesota, Minneapolis, MN 55455, USA.
Department of Mechanical and Aerospace Engineering, University of Missouri, Columbia, MO 65211, USA.
Diagnostics (Basel). 2024 Aug 5;14(15):1695. doi: 10.3390/diagnostics14151695.
This study assesses the efficacy and safety of self-expandable (SE) versus balloon-expandable (BE) stent grafts for managing visceral artery aneurysms (VAAs), focusing on procedural success and complication rates.
We conducted a retrospective analysis of VAA patients treated at our institution from April 2006 to September 2021. The study reviewed patient demographics, aneurysm characteristics, treatment details, and outcomes, including endoleaks.
Among the 23 patients analyzed, splenic artery aneurysms represented 44% of cases. Fifteen patients were treated with balloon-expandable stent grafts (BE SGs), and eight patients were treated with self-expandable stent grafts (SE SGs). For saccular aneurysms, the average neck size was 10.10 ± 8.70 mm in the BE group versus 18.50 ± 3.40 mm in the SE group ( = 0.23), with an average sac size of 20.10 ± 18.9 mm in the BE group versus 15.60 ± 12.7 mm in the SE group ( = 0.16). The average sac-to-neck ratio was 1.69 ± 2.23 in the BE group versus 1.38 ± 0.33 in the SE group ( = 0.63). The BE group exhibited a significantly higher endoleak rate (60%) compared to the SE group (12.5%; = 0.03).
While further investigation is needed to fully assess the outcomes of stent graft treatment for VAAs, initial data show a significantly higher endoleak rate with BE SGs compared to SE SGs. The SE SGs may offer better outcomes due to their superior ability to conform to tortuous and mobile visceral arteries.
本研究评估自膨式（SE）与球囊扩张式（BE）支架型人工血管治疗内脏动脉瘤（VAA）的疗效和安全性，重点关注手术成功率和并发症发生率。
我们对2006年4月至2021年9月在本机构接受治疗的VAA患者进行了回顾性分析。该研究回顾了患者的人口统计学资料、动脉瘤特征、治疗细节及结局，包括内漏情况。
在分析的23例患者中，脾动脉瘤占44%。15例患者接受了球囊扩张式支架型人工血管（BE SGs）治疗，8例患者接受了自膨式支架型人工血管（SE SGs）治疗。对于囊状动脉瘤，BE组的平均瘤颈大小为10.10±8.70mm，而SE组为18.50±3.40mm（P=0.23）；BE组的平均瘤囊大小为20.10±18.9mm，而SE组为15.60±12.7mm（P=0.16）。BE组的平均瘤囊与瘤颈比值为1.69±2.23，而SE组为1.38±0.33（P=0.63）。与SE组（12.5%；P=0.03）相比，BE组的内漏率显著更高（60%）。
虽然需要进一步研究以全面评估支架型人工血管治疗VAA的结局，但初步数据显示，与SE SGs相比，BE SGs的内漏率显著更高。由于SE SGs在顺应迂曲和活动的内脏动脉方面具有更好的能力，可能会带来更好的结局。
