Tsushima Shingo, Shibata Tsuyoshi, Iba Yutaka, Nakajima Tomohiro, Nakazawa Junji, Miura Shuhei, Arihara Ayaka, Mukawa Kei, Iwashiro Yu, Kawaharada Nobuyoshi
Department of Cardiovascular Surgery, Sapporo Medical University, Sapporo 060-8556, Japan.
J Clin Med. 2024 Dec 25;14(1):39. doi: 10.3390/jcm14010039.
Few clinical studies have reported on physician-modified inner-branched endovascular repair (PMiBEVAR) for aortic arch aneurysm. Herein, we evaluate the outcomes of proximal landing zone 2 PMiBEVAR. This retrospective study analyzed data from six patients who underwent zone 2 PMiBEVAR for aortic arch aneurysms at a single center between October 2021 and June 2024. The outcomes were in-hospital mortality and postoperative complications. The median follow-up period was 12.5 (7.3-25) months. Males constituted four out of six cases and females constituted two out of six cases. The patients had a median age of 78.5 (76.5-79.0) years, and the aneurysm diameter was 56 (50-61) mm. Technical success was achieved in 5/6 (83.3%) cases. The median modification and operative times were 56 (45-60) min and 92 (79-308), respectively. Postoperatively, delayed type Ia endoleak and vascular access-site pseudoaneurysm occurred in one patient each. However, no patients experienced other complications. The median hospital stay was 10 (7-41) days, and no deaths or reinterventions occurred after 30 days. During the post-discharge follow-up, the aneurysm diameter remained "unchanged" in four patients, including the one with delayed type Ia endoleak, while two patients experienced "shrinkage". PMiBEVAR for distal aortic arch aneurysm might be effective in improving postoperative outcomes.
很少有临床研究报道过医生改良的内分支血管腔内修复术（PMiBEVAR）治疗主动脉弓动脉瘤的情况。在此，我们评估近端锚定区2的PMiBEVAR的治疗效果。这项回顾性研究分析了2021年10月至2024年6月期间在单一中心接受2区PMiBEVAR治疗主动脉弓动脉瘤的6例患者的数据。观察指标为住院死亡率和术后并发症。中位随访期为12.5（7.3 - 25）个月。6例患者中男性4例，女性2例。患者的中位年龄为78.5（76.5 - 79.0）岁，动脉瘤直径为56（50 - 61）mm。6例中有5例（83.3%）技术成功。中位改良时间和手术时间分别为56（45 - 60）分钟和92（79 - 308）分钟。术后，1例患者出现延迟性Ia型内漏，1例患者出现血管入路部位假性动脉瘤。然而，没有患者出现其他并发症。中位住院时间为10（7 - 41）天，30天后无死亡或再次干预发生。在出院后随访期间，包括1例延迟性Ia型内漏患者在内的4例患者动脉瘤直径保持“不变”，而2例患者出现“缩小”。PMiBEVAR治疗远端主动脉弓动脉瘤可能对改善术后效果有效。
