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血管腔内主动脉修复术后Ⅱ型内漏的经动脉栓塞治疗的技术与临床成功分析

Technical and clinical success analysis of transarterial embolization therapy in type II endoleaks following endovascular aortic repair.

作者信息

Krompaß Kristina, Grunz Jan-Peter, Augustin Anne Marie, Peter Dominik, Schönleben Frank, Bley Thorsten, Kickuth Ralph

机构信息

Department of Diagnostic and Interventional Radiology, University Hospital of Würzburg, Würzburg, Germany.

Department of Radiology, University of Wisconsin-Madison, Madison, United States.

出版信息

Rofo. 2025 Jul;197(7):805-813. doi: 10.1055/a-2384-4601. Epub 2024 Oct 1.

Abstract

This single-center study investigated the safety and efficacy of transarterial embolization of type II endoleaks for expanding aneurysm sacs following endovascular aortic repair (EVAR).36 patients (33 men, 75.9±6.6 years) underwent a total of 50 endovascular procedures for type II endoleak embolization between 2008 and 2023. Analyses included the assessment of patient risk profiles, aneurysm morphology, and endoleak characteristics. Outcome parameters comprised the technical success (i.e., complete lack of blood flow in the previously perfused aneurysm sac) and complication rates, while clinical success was defined as the absence of endoleak persistence or recurrence and freedom from aneurysm enlargement > 0.5 cm over the follow-up period.Transarterial embolization was technically successful in 84% of procedures with a complication rate of 2%. Most interventions were coil-based (72%), while a small number relied solely on liquid embolic agents (14%). Absence of a persisting endoleak in the earliest follow-up could be demonstrated in 75.6% of cases, whereas the absence rate for endoleak recurrence was substantially lower (46.3%). No aneurysm enlargement > 0.5 cm during follow-up was ascertained after 73.2% of interventions.Transarterial embolization represents a safe treatment for type II endoleaks after EVAR. While embolization was moderately effective in preventing further expansion of aneurysms due to endoleak recurrence, most procedures were successful in permanently eliminating the targeted feeder vessels. · Transarterial embolization of type II endoleaks has a high technical success rate.. · The emergence of new feeder vessels may necessitate multiple procedures over time.. · Patient risk profiles did not factor into the clinical outcome.. · Krompaß K, Grunz JP, Augustin AM et al. Technical and clinical success analysis of transarterial embolization therapy in type II endoleaks following endovascular aortic repair. Fortschr Röntgenstr 2024; DOI 10.1055/a-2384-4601.

摘要

这项单中心研究调查了经动脉栓塞治疗II型内漏在血管腔内主动脉修复术(EVAR)后扩大动脉瘤囊方面的安全性和有效性。2008年至2023年间,36例患者(33例男性,年龄75.9±6.6岁)共接受了50次针对II型内漏栓塞的血管腔内手术。分析包括对患者风险概况、动脉瘤形态和内漏特征的评估。结果参数包括技术成功率(即先前灌注的动脉瘤囊内完全无血流)和并发症发生率,而临床成功定义为随访期间内漏无持续或复发,且动脉瘤扩大不超过0.5 cm。

经动脉栓塞在84%的手术中技术成功,并发症发生率为2%。大多数干预措施基于弹簧圈(72%),少数仅依赖液体栓塞剂(14%)。75.6%的病例在最早的随访中可证明无持续内漏,而内漏复发的无发生率则低得多(46.3%)。73.2%的干预措施后随访期间未确定动脉瘤扩大超过0.5 cm。

经动脉栓塞是EVAR后II型内漏的一种安全治疗方法。虽然栓塞在预防因内漏复发导致的动脉瘤进一步扩大方面效果中等,但大多数手术成功地永久性消除了目标供血血管。

· II型内漏的经动脉栓塞技术成功率高。

· 随着时间的推移,新供血血管的出现可能需要多次手术。

· 患者风险概况未影响临床结果。

· 克龙帕斯K、格伦茨JP、奥古斯汀AM等。血管腔内主动脉修复术后II型内漏经动脉栓塞治疗的技术和临床成功分析。《Fortschr Röntgenstr》2024;DOI 10.1055/a - 2384 - 4601 。

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