Takahashi Masao, Nakazawa Ken, Usami Yoko, Natsuyama Yuki, Suzuki Jun, Asami Shiho, Asakura Toshihisa, Yoshitake Akihiro, Shojiguchi Naoko, Satoh Tsugumi, Okada Yoshitaka, Tajima Hiroyuki, Kozawa Eito, Baba Yasutaka
Department of Diagnostic Radiology, Saitama Medical University Hospital, Iruma, Saitama, Japan.
Department of Diagnostic Radiology, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan.
Ann Vasc Dis. 2024 Dec 25;17(4):389-395. doi: 10.3400/avd.oa.24-00044. Epub 2024 Oct 23.
The purpose of this study is to evaluate the feasibility and clinical outcomes of vasa vasorum embolization for preventing continuous aneurysmal expansion after endovascular aneurysm repair (EVAR). We retrospectively reviewed the medical records of patients who underwent vasa vasorum embolization between August 2018 and May 2022. Vasa vasorum embolization was attempted in cases of continuous aneurysmal expansion after EVAR, where the vasa vasorum was identified through catheter angiography. The vasa vasorum was accessed and embolized with a microcatheter. The outcomes of vasa vasorum embolization were evaluated based on technical success, defined as the successful completion of the embolization procedure, and clinical success, defined as the prevention of continuous aneurysmal expansion after the embolization. Seven cases of endoleak with developed vasa vasorum were confirmed by catheter angiography. The mean age was 83.7 years, and the mean aneurysmal diameter was 60.6 mm. Technical success was achieved in 6 cases, while clinical success was not achieved in any of the cases. The mean observation period was 16.5 months, and the mean increase in aneurysmal diameter was 9.7 mm. Although the vasa vasorum embolization is a technically feasible procedure, it is not effective in preventing continuous aneurysmal expansion.
本研究的目的是评估精索内血管栓塞术在预防血管内动脉瘤修复术（EVAR）后动脉瘤持续扩张方面的可行性和临床结果。我们回顾性分析了2018年8月至2022年5月期间接受精索内血管栓塞术的患者的病历。对于EVAR后动脉瘤持续扩张且通过导管血管造影确定了精索内血管的病例，尝试进行精索内血管栓塞术。通过微导管进入精索内血管并进行栓塞。根据技术成功率（定义为栓塞手术成功完成）和临床成功率（定义为栓塞后预防动脉瘤持续扩张）评估精索内血管栓塞术的结果。通过导管血管造影确认了7例伴有发育良好的精索内血管的内漏病例。平均年龄为83.7岁，平均动脉瘤直径为60.6mm。6例获得技术成功，而所有病例均未获得临床成功。平均观察期为16.5个月，动脉瘤直径平均增加9.7mm。虽然精索内血管栓塞术是一种技术上可行的手术，但在预防动脉瘤持续扩张方面无效。
