标准腹主动脉瘤腔内修复手术治疗复杂瘤颈腹主动脉瘤疗效分析  

Outcomes of standard endovascular aneurysm repair for abdominal aortic aneurysm with complex neck anatomical features

作　　者：李文睿 李清乐[1] 张小明[1] 张韬[1] 何长顺[1] 李伟[1] 张学民[1] 焦洋[1] 贺致宾 Li Wenrui;Li Qingle;Zhang Xiaoming;Zhang Tao;He Changshun;Li Wei;Zhang Xuemin;Jiao Yang;He Zhibin(Department of Vascular Surgery,Peking University People's Hospital,Beijing 100044,China;Department of Vascular Surgery,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China)

机构地区：[1]北京大学人民医院血管外科,100044 [2]首都医科大学附属北京友谊医院血管外科,北京100050

出　　处：《中华普通外科杂志》2021年第9期677-680,共4页Chinese Journal of General Surgery

摘　　要：目的:探讨标准腹主动脉瘤腔内修复术(endovascular aneurysm repair,EVAR)治疗复杂瘤颈腹主动脉瘤的疗效。方法:收集2004年1月至2018年12月期间采用标准EVAR治疗的腹主动脉瘤(abdominal aortic aneurysm,AAA)患者的临床资料,按照瘤颈解剖特点分为复杂瘤颈组和非复杂瘤颈组,收集围手术期资料和随访结果,分析标准EVAR治疗两组腹主动脉瘤的结果,评估复杂瘤颈因素对疗效的影响。结果:共纳入CTA和随访资料完整的133例患者,其中复杂瘤颈组88例(66.2%),非复杂瘤颈组45例(33.8%),对比两组的围手术期情况(手术失血量、造影剂用量、平均住院日、技术成功率)及随访结果(远期再干预、远期内漏、动脉瘤直径增大、生存情况)差异均无统计学意义(均P>0.05)。将瘤颈因素与预后指标进行多因素Logistic回归显示瘤颈直径>31 mm与远期再干预相关(OR=24.975,P=0.02)。结论:复杂瘤颈腹主动脉瘤患者接受标准EVAR治疗并未显著增加并发症及死亡率。Objective To explore the outcomes of standard endovascular aneurysm repair(EVAR)for abdominal aortic aneurysm(AAA)with complex neck anatomical features.Methods Clinical data of AAA patients received standard EVAR from Jan 2004 to Dec 2018 were retrospectively collected.Based on pre-operative computed tomography angiography(CTA)data,patients were divided into complex neck group and non-complex neck group to compare the results between them.Results There were 88 patients(66.2%)in complex neck group and 45 patients(33.8%)in non-complex group.There was no significant difference in peri-operative characters(blood loss,contrast volume used,hospital stay time,technical success rate)and follow-up results(late re-intervention,late endoleak,aneurysm enlargement,survival rate),all P>0.05.Multivariant logistic regression analysis revealed neck diameter larger than 31 mm was related with late re-intervention(OR=24.975,P=0.02).Conclusion Standard EVAR for AAA with complex neck characters does not cause higher perioperative complications and less favorable long term survival rate.

关 键 词：主动脉瘤 腹 血管外科手术 复杂瘤颈 腔内修复 

分 类 号：R654.3[医药卫生—外科学]