B Sonesson, M Malina, K Ivancev, M Lindh, B Lindblad, J Brunkwall
{"title":"腹主动脉瘤血管内排除术后肾下动脉瘤颈部扩张。","authors":"B Sonesson, M Malina, K Ivancev, M Lindh, B Lindblad, J Brunkwall","doi":"10.1583/1074-6218(1998)005<0195:DOTIAN>2.0.CO;2","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>To determine the fate of the infrarenal aneurysm neck and suprarenal aorta after endovascular exclusion of abdominal aortic aneurysms (AAAs).</p><p><strong>Methods: </strong>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).</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":79443,"journal":{"name":"Journal of endovascular surgery : the official journal of the International Society for Endovascular Surgery","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"1998-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"69","resultStr":"{\"title\":\"Dilatation of the infrarenal aneurysm neck after endovascular exclusion of abdominal aortic aneurysm.\",\"authors\":\"B Sonesson, M Malina, K Ivancev, M Lindh, B Lindblad, J Brunkwall\",\"doi\":\"10.1583/1074-6218(1998)005<0195:DOTIAN>2.0.CO;2\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>To determine the fate of the infrarenal aneurysm neck and suprarenal aorta after endovascular exclusion of abdominal aortic aneurysms (AAAs).</p><p><strong>Methods: </strong>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).</p><p><strong>Results: </strong>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). 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引用次数: 69
摘要
目的:探讨腹主动脉瘤(AAAs)血管内排除术后肾下动脉瘤颈部及肾上主动脉的预后。方法:1994年1月至1995年12月间,34例患者行AAA血管内修复术,采用聚酯材料自制支架和改良自膨胀Gianturco z型支架缝合于移植口。31例患者可随访。在肠系膜上动脉(SMA)水平,采用螺旋计算机断层扫描测量动脉瘤颈和肾上主动脉植入前后的直径。结果:平均随访25个月。肾下动脉瘤颈直径明显增加(+ 1.65 mm, p = 0.002),而主动脉在SMA水平上没有明显增加(+0.52 mm, p = 0.100)。在测量水平附近放置支架组(n = 20)与未放置支架组(n = 11, p = 0.790)相比,肾下颈直径变化无差异。植入前肾下颈大小与肾下颈直径变化无相关性(r = 0.14, p = 0.488)。SMA水平的主动脉直径变化与肾下颈之间无相关性(r = 0.10, p = 0.603)或相关性(卡方检验,p = 0.211)。结论:本研究显示,在使用该装置进行血管内AAA修复后,动脉瘤颈部明显扩张,而肾上主动脉没有明显扩张。这些发现的临床意义尚不清楚。这种在动脉瘤颈部的扩张是否会影响支架移植物的长期附着还有待进一步研究。
Dilatation of the infrarenal aneurysm neck after endovascular exclusion of abdominal aortic aneurysm.
Purpose: To determine the fate of the infrarenal aneurysm neck and suprarenal aorta after endovascular exclusion of abdominal aortic aneurysms (AAAs).
Methods: 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).
Results: 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.
Conclusions: 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.