韩国医生改良型血管内支架移植物治疗复杂腹主动脉瘤的中期疗效:一项回顾性研究。

IF 1.2 4区 医学 Q3 SURGERY Annals of Surgical Treatment and Research Pub Date : 2024-02-01 Epub Date: 2024-01-29 DOI:10.4174/astr.2024.106.2.106
Hyo Jun Kim, Eun-Ah Jo, Hyung Sub Park, Taeseung Lee, Sukgu Han
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引用次数: 0

摘要

目的:医生改良型血管内支架移植物(PMEG)是治疗复杂性腹主动脉瘤(AAA)的良好选择,尤其适用于无法进行开放式修复的高风险患者,以及无法使用商业化栅栏式装置的患者。我们报告了单中心使用 PMEG 治疗复杂性 AAA 的经验:我们回顾性分析了 2016 年 11 月至 2020 年 9 月在本院接受 PMEG 修复 AAA 的患者。分析了人口统计学数据、解剖学特征、围术期和术后结果、主要不良事件和 30 天死亡率:结果:我们发现12名患者因复杂性AAA接受了PMEG手术。平均年龄为 74 岁,AAA 最大直径为 58.1 毫米。治疗指征包括 4 个即将破裂或已破裂的动脉瘤、2 个霉菌性动脉瘤和 6 个无症状病例。技术成功率为 91.7%。有 7 例患者(58.3%)观察到动脉瘤囊消退,其中 2 例完全消退。3个月时有1例因霉菌性动脉瘤而死亡。此外,还有 1 例术后并发症,即一过性肾衰竭,需要进行临时透析。1年后,有1例初次插管失败导致的分支闭塞,2例1A型内漏,1例开放性剥离:结论:PMEG 的技术失败率较低,中期支架耐久性和囊稳定性可接受,与传统的血管内动脉瘤修补术相当。结论:PMEG 的技术失败率低,中期支架耐久性和囊稳定性可接受,与传统的血管内动脉瘤修补术相当。尽管病例数较少,但囊回归率较高,不过还需要更长时间的随访。
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Midterm outcomes of physician-modified endovascular stent grafts for the treatment of complex abdominal aortic aneurysms in Korea: a retrospective study.

Purpose: Physician-modified endovascular stent grafts (PMEG) are a good treatment option for complex abdominal aortic aneurysms (AAAs), especially in high-risk patients not amenable to open repair, and when commercial fenestrated devices are not available. We report our single-center experience with PMEG for the treatment of complex AAAs.

Methods: We retrospectively reviewed patients who underwent PMEG repair for AAA from November 2016 to September 2020 at our institution. Demographic data, anatomic characteristics, perioperative and postoperative outcomes, major adverse events, and 30-day mortality were analyzed.

Results: We identified 12 patients who underwent PMEG for complex AAA. The mean age was 74 years and the mean maximal AAA diameter was 58.1 mm. Indications for treatment included 4 impending or contained ruptures, 2 mycotic aneurysms, and 6 symptomatic cases. The technical success rate was 91.7%. Aneurysm sac regression was observed in 7 patients (58.3%), including 2 cases of complete regression. There was 1 aneurysm-related mortality at 3 months due to mycotic aneurysm. Also, there was 1 postoperative complication case of transient renal failure requiring temporary dialysis. At 1 year, there was 1 branch occlusion from the initial failed cannulation case and 2 type 1A endoleaks, and there was 1 case of open explantation.

Conclusion: PMEG showed a low technical failure rate and acceptable midterm stent durability and sac stability, comparable to conventional endovascular aneurysm repair. Despite the small number of cases, there was a tendency for a high sac regression rate, although longer follow-up is needed.

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CiteScore
2.30
自引率
7.10%
发文量
75
期刊介绍: Manuscripts to the Annals of Surgical Treatment and Research (Ann Surg Treat Res) should be written in English according to the instructions for authors. If the details are not described below, the style should follow the Uniform Requirements for Manuscripts Submitted to Biomedical Journals: Writing and Editing for Biomedical Publications available at International Committee of Medical Journal Editors (ICMJE) website (http://www.icmje.org).
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