[1]李文睿 李清乐* 张小明 张韬 李伟 张学民 焦洋 蒋京军.腹主动脉瘤腔内修复术后I型内漏的处理[J].中国微创外科杂志,2019,01(3):239-242.
　Li Wenrui,Li Qingle,Zhang Xiaoming,et al.Management of Type Ⅰ Endoleak After Endovascular Aneurysm Repair for Abdominal Aortic Aneurysm[J].Chinese Journal of Minimally Invasive Surgery,2019,01(3):239-242.
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腹主动脉瘤腔内修复术后I型内漏的处理()
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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3期
页码:
239-242
栏目:
临床研究
出版日期:
2019-03-25

文章信息/Info

Title:
Management of Type Ⅰ Endoleak After Endovascular Aneurysm Repair for Abdominal Aortic Aneurysm
作者:
李文睿 李清乐* 张小明 张韬 李伟 张学民 焦洋 蒋京军
（北京大学人民医院血管外科，北京100044）
Author(s):
Li Wenrui;  Li Qingle;  Zhang Xiaoming;  et al.
Department of Vascular Surgery, Peking University People’s Hospital, Beijing 100044, China
关键词:
腹主动脉瘤; 腔内修复手术; 内漏; 再干预
Keywords:
Abdominal aortic aneurysm; Endovascular aneurysm repair; Endoleak; Reintervention
文献标志码:
A
摘要:
目的探讨腹主动脉瘤腔内修复术后Ⅰ型内漏的处理方法和结果。方法回顾性分析2006年4月~2018年8月因腹主动脉瘤腔内修复（endovascular aortic repair，EVAR）术后Ⅰ型内漏接受再干预的临床资料，14例共17处Ⅰ型内漏（3例双侧Ⅰb型），其中Ⅰa型4处，Ⅰb型13处。均根据CT血管造影（computed tomography angiography，CTA）明确内漏类型，决定手术方式，随访并评估治疗结果。结果技术成功率100%。1例切口淋巴漏，加压包扎治疗。术后随访4~97个月，中位数41个月。2例（14.3%）因内漏复发行再干预治疗。2例（14.3%）死亡，其中1例可疑为主动脉相关事件。结论根据EVAR术后Ⅰ型内漏的部位、原因，施行个体化治疗方案，可获得满意的疗效。
Abstract:
ObjectiveTo analyze the management strategy of type Ⅰ endoleak after endovascular aortic repair (EVAR) for abdominal aneurysm repair.Methods Records of patients received reintervention for type Ⅰ endoleak after EVAR from April 2006 to August 2018 were reviewed. There were totally 17 type Ⅰ endoleaks in 14 patients (3 cases of bilateral type Ⅰb endoleak), including 4 type Ⅰa endoleaks and 13 type Ⅰb endoleaks. Computed tomography angiography (CTA) was used to clarify the endoleak type and to determine the treatment method. The patients were followed up and the curative effects were evaluated.ResultsThe technical success rate was 100%. Incision lymphorrhagia occurred in 1 patient and was treated with compression therapy. The patients were followed for 4-97 months (median, 41 months). Two patients (14.3%) received reintervention for recurrent endoleaks. Two patients (14.3%) died during followups with one possible aortic event related. ConclusionTreatment of type Ⅰ endoleaks after EVAR may achieve satisfactory results with individualized strategy.

参考文献/References:

[1]Andersen RM,Henriksen DP,Mafi HM,et al.A longtime followup study of a singlecenter endovascular aneurysm repair (EVAR) endoleak outcomes.Vasc Endovasc Surg,2018,52(7):505-511.
2White G H,Yu W,May J,et al.Endoleak as a complication of endoluminal grafting of abdominal aortic aneurysms:classification,incidence,diagnosis,and management.J Endovasc Surg,1997,4(2):152-168.
[3]Hobo R,Buth J.Secondary interventions following endovascular abdominal aortic aneurysm repair using current endografts.A EUROSTAR report.J Vasc Surg,2006,43(5):896-902.e1.
[4]高斌，符伟国.腹主动脉瘤腔内修复术后内漏的诊治.中国微创外科杂志,2004,4(1):12-13.
[5]刘长建，刘昭.腹主动脉瘤腔内修复术后内漏的诊断和处理.中国血管外科杂志(电子版),2014,6(3):129-131.
[6]Moll FL,Powell JT,Fraedrich G,et al.Management of abdominal aortic aneurysms clinical practice guidelines of the European society for vascular surgery.Eur J Vasc Endovasc Surg，2011,41(Suppl 1):S1-S58.
[7]Lo RC,Buck DB,Herrmann J,et al.Risk factors and consequences of persistent type II endoleaks.J Vasc Surg,2016,63(4):895-890.
[8]Marcelin C,Le BY,Petitpierre F,et al.Safety and efficacy of embolization using Onyx of persistent type Ⅱ endoleaks after abdominal endovascular aneurysm repair.Diagn Interv Imaging,2017,98(6):491-497.
[9]Dias AP,Farivar BS,Steenberge SP,et al.Management of failed endovascular aortic aneurysm repair with explantation or fenestratedbranched endovascular aortic aneurysm repair.J Vasc Surg,2018,68(6):1676-1687.
[10]Millen AM,Osman K,Antoniou GA,et al.Outcomes of persistent intraoperative type Ia endoleak after standard endovascular aneurysm repair.J Vasc Surg,2015,6(5):1185-1191.

备注/Memo

备注/Memo:
*通讯作者，Email：mailtole@126.com
更新日期/Last Update: 2019-06-04