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癌症患者内脏动脉损伤治疗中Viabahn覆膜支架闭塞的临床结局及危险因素

Clinical Outcomes and Risk Factors for Viabahn Stent Graft Occlusion in the Treatment of Visceral Arterial Injuries in Cancer Patients.

作者信息

Koretsune Yuji, Higashihara Hiroki, Toyoda Satoshi, Yamakawa Miho, Mikami Koji, Maeda Noboru, Yukimoto Hiroshi, Nagai Keisuke, Nakamura Masahisa, Tomiyama Noriyuki

机构信息

Department of Diagnostic and Interventional Radiology, Osaka University Graduate School of Medicine, Japan.

Department of High Precision Image-guided Percutaneous Intervention, Osaka University Graduate School of Medicine, Japan.

出版信息

Interv Radiol (Higashimatsuyama). 2024 Aug 7;9(3):172-179. doi: 10.22575/interventionalradiology.2023-0040. eCollection 2024 Nov 1.

Abstract

PURPOSE

This study aimed to evaluate the clinical outcomes of placing Viabahn stent grafts in visceral arterial injuries and identify the risk factors associated with stent graft occlusion.

MATERIAL AND METHOD

This multicenter, retrospective study included 29 procedures performed on 26 patients who underwent Viabahn stent graft placement between December 2017 and November 2022. We evaluated technical and clinical success rates, periprocedural complications, and stent graft patency using contrast-enhanced computed tomography. We conducted univariate analysis to examine the risk factors associated with Viabahn stent graft occlusion.

RESULT

The technical success rate was 96.6% (28 of 29), and the clinical success rate was 86.2% (25 of 29). The periprocedural complication rate was 17.2% (5 of 29), consisting of 4 mild adverse events and 1 patient death. The stent graft patency rates at 1, 3, 6, 12, and 24 months were 85%, 84.2%, 77.8%, 66.7%, and 50%, respectively. Univariate analysis indicated significant correlations between the lack of antiplatelet medication ( = .00074) and SG oversize ≥ 20% ( = .047).

CONCLUSIONS

This trial demonstrated the safety and effectiveness of Viabahn stent graft placement for visceral arterial injuries with high patency rates. Additionally, this study identified the lack of antiplatelet treatment and Viabahn oversize ≥ 20% as significant risk factors for Viabahn stent graft blockage in visceral arterial injuries.

摘要

目的

本研究旨在评估在内脏动脉损伤中植入Viabahn覆膜支架的临床效果,并确定与支架闭塞相关的危险因素。

材料与方法

这项多中心回顾性研究纳入了2017年12月至2022年11月期间26例接受Viabahn覆膜支架植入术的患者所进行的29例手术。我们使用对比增强计算机断层扫描评估技术成功率和临床成功率、围手术期并发症以及支架通畅情况。我们进行单因素分析以检查与Viabahn覆膜支架闭塞相关的危险因素。

结果

技术成功率为96.6%(29例中的28例),临床成功率为86.2%(29例中的25例)。围手术期并发症发生率为17.2%(29例中的5例),包括4例轻度不良事件和1例患者死亡。支架在1、3、6、12和24个月时的通畅率分别为85%、84.2%、77.8%、66.7%和50%。单因素分析表明,未使用抗血小板药物(P = .00074)和支架尺寸过大≥20%(P = .047)之间存在显著相关性。

结论

该试验证明了Viabahn覆膜支架植入术治疗内脏动脉损伤的安全性和有效性,通畅率较高。此外,本研究确定未进行抗血小板治疗和Viabahn尺寸过大≥20%是内脏动脉损伤中Viabahn覆膜支架阻塞的重要危险因素。

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