May J, White G H, Yu W, Waugh R C, Stephen M S, McGahan T, Harris J P
Department of Vascular Surgery, Royal Prince Alfred Hospital, Australia.
Eur J Vasc Endovasc Surg. 1995 Jul;10(1):51-9. doi: 10.1016/s1078-5884(05)80198-4.
The aim of this study was to report the outcome of endoluminal grafting of abdominal aortic aneurysms (AAA) with special reference to complications.
Between May 1992 and August 1994 endoluminal repair of aneurysms was undertaken in 61 patients. In 53 the aneurysm was aortic and these are the basis of this report. In patients with AAA all procedures were elective and were performed in the operating room with the patient draped for an open repair in the event of failed endoluminal repair. The configuration of the endografts was tubular 36, tapered aortoiliac/aortofemoral 12 and bifurcated 5. Radiographic guidance was used to pass the endografts into the aorta via a delivery sheath introduced through the femoral or iliac arteries.
Successful endoluminal repair of AAA was achieved in 43 of 53(81%) patients. In the remaining 10 patients, endoluminal repair was abandoned in favour of an open repair. There were 17(32%) local/vascular and 13(25%) systemic/remote remote complications. The sum of these complications occurring in successful endoluminal repairs and those complications leading to failure of endoluminal repair was 40(75%). There were two cardiac deaths within 30 days in patients undergoing endoluminal repair (both procedure related) and four late deaths (unrelated to aneurysm repair). Three of the late deaths were in patients undergoing endoluminal repair and one endoluminal converted to open repair.
Endoluminal repair of AAA in our experience has a low perioperative (< 30 days) mortality rate (3.7%) but a high morbidity rate (75%). It is recommended that complications be classified into three groups: systemic/remote and local/vascular (following successful endoluminal repair) plus those complications leading to failure of endoluminal repair. The first group is composed of medical complications while the latter two groups comprise those surgical complications directly related to the endoluminal technique.
本研究旨在报告腹主动脉瘤（AAA）腔内移植术的结果，并特别提及并发症。
1992年5月至1994年8月期间，对61例患者进行了动脉瘤腔内修复术。其中53例为主动脉瘤，这些是本报告的基础。对于AAA患者，所有手术均为择期手术，在手术室进行，若腔内修复失败，患者需铺巾准备进行开放修复。腔内移植物的构型为管状36例，锥形主髂动脉/主股动脉型12例，分叉型5例。通过经股动脉或髂动脉插入的输送鞘，在影像学引导下将腔内移植物送入主动脉。
53例患者中有43例（81%）成功进行了AAA腔内修复。其余10例患者放弃腔内修复而选择开放修复。有17例（32%）局部/血管并发症和13例（25%）全身/远处并发症。成功的腔内修复中出现的这些并发症以及导致腔内修复失败的并发症总数为40例（75%）。腔内修复患者中有2例在30天内发生心脏死亡（均与手术相关），4例为晚期死亡（与动脉瘤修复无关）。其中3例晚期死亡患者接受了腔内修复，1例腔内修复转为开放修复。
根据我们的经验，AAA腔内修复术围手术期（<30天）死亡率低（3.7%），但发病率高（75%）。建议将并发症分为三组：全身/远处和局部/血管（腔内修复成功后），以及导致腔内修复失败的并发症。第一组由医疗并发症组成，而后两组包括与腔内技术直接相关的手术并发症。
