栓塞治疗腹主动脉瘤腔内修复术后Ⅱ型内漏的单中心经验总结  

Embolization of type Ⅱ endoleaks after endovascular repair of abdominal aortic aneurysm:a single center experience

作　　者：唐涵斐 郭大乔[1] 唐骁[1] 史振宇[1] 王利新[1] 林长泼 严栋[1] 符伟国[1] 

机构地区：[1]复旦大学附属中山医院血管外科复旦大学血管外科研究所,上海200032

出　　处：《中国普外基础与临床杂志》2017年第1期14-17,共4页Chinese Journal of Bases and Clinics In General Surgery

摘　　要：目的总结栓塞治疗腹主动脉瘤腔内修复(EVAR)术后Ⅱ型内漏的经验,并评估该方法的可行性及安全性。方法回顾性分析笔者所在中心自2009年1月至2014年12月期间完成的14例栓塞治疗EVAR术后Ⅱ型内漏患者的临床资料,观察手术结果、围手术期及术后并发症及随访情况。结果 14例患者栓塞治疗EVAR术后Ⅱ型内漏的技术成功率为100%(14/14),即刻临床成功率为100%(14/14),手术时间(124.3±11)min,每例患者使用造影剂(127±15)mL,每例患者手术使用弹簧圈(7±2)个。围手术期间1例患者术后出现左下肢麻木,其余患者无穿刺导致的并发症,无死亡等严重并发症,患者均顺利出院。12例患者获得3~57个月(平均17.3个月)的随访,1例仅栓塞供血动脉的患者及另2例仅栓塞瘤腔的患者在术后发现内漏复发,但瘤体未明显增大,未再次接受腔内治疗,继续随访。结论栓塞治疗EVAR术后Ⅱ型内漏的患者是安全的,能够有效地阻止动脉瘤瘤腔的进一步扩张。由于Ⅱ型内漏复发率高,术后的随访工作尤为重要。Objective To evaluate the safety and efficacy of treating type Ⅱ endoleaks after endovascular aneurysm repair （EVAR） of abdominal aortic aneurysms with coil embolization. Methods A retrospective review of patients with type Ⅱ endoleaks treated with coil embolization was performed. Data regarding the technical, clinical, and imaging outcomes during perioperation and followed-up were collected. Results The technical success rate and the initial clinical success rate of treating type Ⅱ endoleaks with coil embolization were 100% （14/14）. The mean operating time was （124.3±11） min, a mean of （127±15） mL contrast agent and a mean of （7±2） coils were used. During perioperation, one patient suffered left limb paralysis, all the patients were discharged with no perioperative mortality. Twelve patients were followed-up. During the period of 3 to 57 months of followed-up （average： 17.3 months）, Type Ⅱ endoleaks reoccurred in one patient with coil embolization of the feeding vessels alone and two patients with coil embolization of the aneurysm sac alone. Since the aneurysms did not enlarge during the followed-up, these 3 patients continued followed-up without reinterventions. Conclusion Treating type Ⅱ endoleaks with coil embolization appears to be safe, and it can prevent aneurysm sac enlargement effectively. Because of the high risk of reoccurrence, follow-up after embolization is important.

关 键 词：腹主动脉瘤 Ⅱ型内漏 腔内修复 栓塞 

分 类 号：R654.3[医药卫生—外科学]