May J, White G H, Yu W, Waugh R, Stephen M S, Harris J P
Department of Vascular Surgery, Royal Prince Alfred Hospital, Sydney, NSW.
Med J Aust. 1996 Nov 18;165(10):549-51. doi: 10.5694/j.1326-5377.1996.tb138640.x.
To report the outcome in our first 100 patients with abdominal aortic aneurysms repaired by the endoluminal method.
Analysis of concurrently collected data of patients undergoing repair of an aortic aneurysm. The technique involves the delivery of an endograft into the abdominal aorta by means of a sheath inserted through the femoral or iliac artery. Clinical examination and contrast-enhanced computed tomography (CT) were performed within 10 days, at six months and then annually after operation.
Royal Prince Alfred Hospital, Sydney, a tertiary referral teaching hospital.
100 patients, seven women and 93 men, with a mean age of 70 years (range, 46-87), treated between May 1992 and December 1995. Because of comorbidities, 43 of the patients had been considered unsuitable for conventional open repair at other medical centres. Our criteria for inclusion were the presence of a 1.5-cm or greater segment of thrombus-free aorta between the lowermost renal artery and the commencement of the aneurysm, and iliac arteries allowing access to the aorta from the groin.
(i) Need to convert to open repair; (ii) damage to the arteries from sheath insertion; (iii) communication between the aneurysmal sac and the circulation; (iv) death within 30 days; (v) effect on aneurysmal diameter.
Endografts were successfully deployed in 88 patients. In the remaining 12 patients endoluminal repair was converted to open repair. There were five deaths within 30 days of the operation, including three in the failed group. Damage to the femoral or iliac arteries from sheath insertion occurred in five patients. These were repaired without the need to convert to open repair. No patients were lost to follow-up (62 patients have been followed up for at least six months). Contrast-enhanced computed tomography shows progressive diminution in maximal transverse diameter of the aneurysms with time, after successful exclusion of the aneurysmal sac from the general circulation.
Endoluminal repair of abdominal aortic aneurysms is feasible and this method of repair is durable in mid-term follow-up.
报告我们采用腔内修复术治疗的首批100例腹主动脉瘤患者的治疗结果。
对同期收集的接受主动脉瘤修复患者的数据进行分析。该技术是通过经股动脉或髂动脉插入的鞘管将腔内移植物输送至腹主动脉。术后10天内、6个月时以及之后每年进行临床检查和增强计算机断层扫描（CT）。
悉尼皇家阿尔弗雷德王子医院，一家三级转诊教学医院。
100例患者，7例女性和93例男性，平均年龄70岁（范围46 - 87岁），于1992年5月至1995年12月期间接受治疗。由于存在合并症，43例患者在其他医疗中心被认为不适合进行传统的开放修复。我们的纳入标准是在最低肾动脉与动脉瘤起始部之间存在一段1.5厘米或更长的无血栓主动脉段，且髂动脉允许从腹股沟进入主动脉。
（i）转为开放修复的必要性；（ii）鞘管插入对动脉的损伤；（iii）动脉瘤囊与循环系统之间的连通情况；（iv）30天内死亡；（v）对动脉瘤直径的影响。
88例患者成功植入腔内移植物。其余12例患者的腔内修复转为开放修复。术后30天内有5例死亡，其中3例在修复失败组。鞘管插入导致股动脉或髂动脉损伤的有5例患者。这些患者无需转为开放修复即可修复。无患者失访（62例患者已随访至少6个月）。增强计算机断层扫描显示，在成功将动脉瘤囊排除于体循环后，动脉瘤的最大横径随时间逐渐减小。
腹主动脉瘤的腔内修复是可行的，且在中期随访中这种修复方法效果持久。
