[1]韩晓峰 郭曦** 刘光锐 李铁铮 黄连军.弹簧圈栓塞治疗腹主动脉瘤腔内修复术后持续性Ⅱ型内漏[J].中国微创外科杂志,2019,01(2):132-136.
　Han Xiaofeng,Guo Xi,Liu Guangrui,et al.Coil Embolization of Persistent Type Ⅱ Endoleak After Endovascular Aortic Repair for Abdominal Aortic Aneurysm[J].Chinese Journal of Minimally Invasive Surgery,2019,01(2):132-136.
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弹簧圈栓塞治疗腹主动脉瘤腔内修复术后持续性Ⅱ型内漏()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
01
期数:
2019年2期
页码:
132-136
栏目:
临床研究
出版日期:
2019-02-25

文章信息/Info

Title:
Coil Embolization of Persistent Type Ⅱ Endoleak After Endovascular Aortic Repair for Abdominal Aortic Aneurysm
作者:
韩晓峰 郭曦** 刘光锐 李铁铮 黄连军
（首都医科大学附属北京安贞医院介入诊疗科，北京100029）
Author(s):
Han Xiaofeng;  Guo Xi;  Liu Guangrui;  et al.
Department of Diagnostic and Interventional Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
关键词:
Ⅱ型内漏; 腹主动脉瘤腔内修复术; 弹簧圈栓塞治疗
Keywords:
Type Ⅱ endoleak; Endovascular aortic repair; Coil embolism
文献标志码:
A
摘要:
目的探讨分支血管栓塞治疗腹主动脉瘤腔内修复（endovascular aneurysm repair，EVAR）术后持续性Ⅱ型内漏的效果。方法回顾性分析2014年6月~2018年6月312例EVAR资料，268例资料完整，复查主动脉CTA诊断Ⅱ型内漏34例（12.7%），其中5例为持续性Ⅱ型内漏，均为男性，年龄（64.8±10.0）岁，行分支血管弹簧圈栓塞。结果5例Ⅱ型内漏均为肠系膜下动脉逆灌注瘤腔，其中经肠系膜上动脉-肠系膜下动脉侧支血管汇入瘤腔3例，腹腔干动脉-肠系膜下动脉侧支血管汇入瘤腔2例。术前主动脉CTA和术中DSA造影均见迂曲血管及支架外瘤腔内对比剂着色。5例均经股动脉入路，避开重要分支血管行弹簧圈栓塞瘤腔供血分支动脉，均获技术成功。术后随访3~18个月，平均10个月，Ⅱ型内漏供血分支动脉栓塞确切，瘤腔体积缩小率4.8%~25.5%，(12.7±8.1)%，无严重并发症发生。结论对于EVAR术后持续性Ⅱ型内漏，分支血管栓塞治疗操作简单安全，疗效确切。
Abstract:
ObjectiveTo assess the efficiency of branch artery embolism in inhibiting the persistent type Ⅱ endoleak (T2EL) after endovascular aneurysm repair (EVAR).MethodsA retrospective analysis was made on clinical data of 312 cases of EVAR in our hospital from June 2014 to June 2018. There were 268 cases having entire computed tomography angiography (CTA). A total of 34 cases (12.7%) of type Ⅱ endoleak were diagnosed by aortic CTA, 5 of which showed persistent endoleak. All the 5 patients were male, aged (64.8±10.0) years old, and were treated with criminal branch artery embolism.ResultsAll of the criminal branch arteries for retrograde perfusion in aneurysm sac were inferior mesenteric artery (IMA), including 3 cases via collateral circulation from the superior mesenteric artery (SMA) to IMA, and 2 cases though collateral branch from celiac trunk artery to IMA into sac. Both preoperative aortic CTA and intraoperative digital subtraction angiography (DSA) imaging displayed contrast media agent staining in aneurysm sac between stentgraft and aneurysm wall by tortuous criminal branch vessel. All the 5 patients underwent coil embolism to IMA proximal segment to avoid vital branch vessels occlusion though femoral artery approach, the technical success rate being 100%. Followups for 3-18 months (mean, 10 months) showed IMA embolism was confirmed and the mean sac volume decreased rate was 4.8%-25.5% ［mean, (12.7±8.1)%］ without serious complications.ConclusionBranch arterial embolism for patients with persistent T2EL after EVAR is a simple, safe and effective therapy strategy to inhibit sac expansion, with longterm efficiency further investigation required.

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备注/Memo

备注/Memo:
基金项目：国家重点研发计划（2017YFC1308005）**通讯作者，Email：13911048625@163.com
更新日期/Last Update: 2019-04-28