Sonesson B, Malina M, Ivancev K, Lindh M, Lindblad B, Brunkwall J
Department of Vascular and Renal Diseases, Lund University, Malmö University Hospital, Sweden.
J Endovasc Surg. 1998 Aug;5(3):195-200. doi: 10.1583/1074-6218(1998)005<0195:DOTIAN>2.0.CO;2.
To determine the fate of the infrarenal aneurysm neck and suprarenal aorta after endovascular exclusion of abdominal aortic aneurysms (AAAs).
Thirty-four patients underwent endovascular AAA repair between January 1994 and December 1995 using custom-made stent-grafts constructed from polyester graft material and modified self-expanding Gianturco Z-stents sutured to the graft orifices. Thirty-one patients were available for follow-up. Pre- and postimplantation diameters were measured using spiral computed tomography in the infrarenal aneurysm neck and the suprarenal aorta at the level of the superior mesenteric artery (SMA).
The mean follow-up time was 25 months. There was a significant increase of the diameter of the infrarenal aneurysm neck (+ 1.65 mm, p = 0.002), but not in the aorta at the level of the SMA (+0.52 mm, p = 0.100). There was no difference in the change in diameter in the infrarenal neck in the group with a stent adjacent to the level of measurement (n = 20) compared with the group without an adjacent stent (n = 11, p = 0.790). There was no correlation between preimplantation size of the infrarenal neck and its diameter change (r = 0.14, p = 0.488). There was no correlation (r = 0.10, p = 0.603) or association (chi-square test, p = 0.211) between aortic diameter change at the level of the SMA and the infrarenal neck.
This investigation shows a significant dilatation of the infrarenal aneurysm neck, but not in the suprarenal aorta, after endovascular AAA repair with this device. The clinical significance of these findings is unclear. Whether such a dilatation in the infrarenal aneurysm neck may affect the long-term attachment of stent-grafts remains to be shown in the future.
确定腹主动脉瘤（AAA）腔内隔绝术后肾下动脉瘤颈及肾上腹主动脉的转归。
1994年1月至1995年12月，34例患者接受了腔内AAA修复术，使用由聚酯移植材料制成的定制支架型人工血管以及缝合于移植口的改良自膨式Gianturco Z形支架。31例患者可供随访。在肾下动脉瘤颈及肠系膜上动脉（SMA）水平的肾上腹主动脉处，于植入前和植入后使用螺旋计算机断层扫描测量直径。
平均随访时间为25个月。肾下动脉瘤颈直径显著增加（+1.65 mm，p = 0.002），但SMA水平的主动脉直径未增加（+0.52 mm，p = 0.100）。在测量水平附近有支架的组（n = 20）与无相邻支架的组（n = 11，p = 0.790）相比，肾下颈部直径变化无差异。肾下颈部植入前大小与其直径变化之间无相关性（r = 0.14，p = 0.488）。SMA水平主动脉直径变化与肾下颈部之间无相关性（r = 0.10，p = 0.603）或关联（卡方检验，p = 0.211）。
本研究表明，使用该装置进行腔内AAA修复术后，肾下动脉瘤颈有显著扩张，但肾上腹主动脉无扩张。这些发现的临床意义尚不清楚。肾下动脉瘤颈的这种扩张是否会影响支架型人工血管的长期附着，仍有待未来证实。
