腹主动脉瘤腔内修复术后Ⅱ型内漏相关再干预的危险因素分析  

Analyze of risk factors for re-intervention related to type II endoleak after endovascular abdominal aortic aneurysm repair

作　　者：额尔德木图[1] 高占峰[1] 胡利强[1] 周崇彬[1] E Erdemutu;Gao Zhanfeng;Hu Liqiang;Zhou Chongbin(Department of Vascular Surgery,the Affiliated Hospital of Inner Mongolia Medical University,Hohhot 010050,Inner Mongolia,China)

机构地区：[1]内蒙古医科大学附属医院血管外科,内蒙古呼和浩特010050

出　　处：《血管与腔内血管外科杂志》2023年第10期1153-1156,1187,M0002,共6页Journal of Vascular and Endovascular Surgery

基　　金：内蒙古自治区自然科学基金项目(2023QN08015)。

摘　　要：目的探讨腹主动脉瘤(AAA)患者腔内修复术(EVAR)后Ⅱ型内漏(T2EL)相关再干预的危险因素及危险阈值。方法收集2015年1月至2021年12月于内蒙古医科大学附属医院进行EVAR的97例AAA患者的临床资料,根据是否进行了术后T2EL相关再干预将患者分为再干预组(n=14)和非再干预组(n=83)。比较两组患者的临床特征。分析两组患者AAA的形态学特征,确定T2EL的发生情况。分析AAA患者EVAR术后T2EL相关再干预的危险因素并确定其危险阈值,进而评估AAA患者EVAR术后T2EL相关再干预的风险。结果再干预组患者的吸烟比例、高血压比例均高于非再干预组患者(P﹤0.05)。再干预组患者的瘤体最大直径、肠系膜下动脉(IMA)直径、腰动脉(LA)数量均明显大于非再干预组患者(P﹤0.01)。多因素分析结果显示,瘤体最大直径、IMA直径、LA数量均是AAA患者EVAR术后T2EL相关再干预的独立危险因素(P﹤0.05)。受试者工作特征(ROC)曲线分析结果显示,瘤体最大直径≥56.85 mm、IMA直径≥2.95 mm的AAA患者在EVAR术后因T2EL而再次干预的风险较高。结论具有危险因素的AAA患者EVAR术后T2EL相关再干预的可能性较高,而高于IMA直径和瘤体最大直径风险阈值的AAA患者EVAR术后T2EL相关再干预的可能性更高。Objective To investigate the risk factors and dangerous thresholds of re-intervention related to type II endoleak(T2EL)in patients with abdominal aortic aneurysm(AAA)after endovascular aortic repair(EVAR).Method The clinical data of 97 AAA patients who underwent EVAR at the Affiliated Hospital of Inner Mongolia Medical University from January 2015 to December 2021 were collected.Patients were divided into re-intervention group(n=14)and nonre-intervention group(n=83)according to whether T2EL-related re-intervention after surgery was performed.The clinical features of the two groups of patients were compared.The morphological characteristics of AAA in the two groups of patients were analyzed to determine the occurrence of T2EL.The risk factors of T2EL-related re-intervention after EVAR in AAA patients were analyzed and their risk thresholds were determined,and then the risk of T2EL-related reintervention in AAA patients after EVAR was evaluated.Result The proportion of smoking and hypertension in the re-intervention group were higher than those in the non-re-intervention group(P<0.05).The maximum diameter of the aneurysm body,inferior mesenteric artery(IMA)diameter,and lumbar artery(LA)number of patients in the re-intervention group were significantly greater than those in the non-re-intervention group(P<0.01).Multivariate analysis results showed that the maximum diameter of the aneurysm body,IMA diameter,and LA number were independent risk factors for T2EL-related re-intervention after EVAR in AAA patients(P<0.05).Receiver operating characteristic(ROC)curve analysis results showed that AAA patients with maximum diameter of the aneurysm body≥56.85 mm and IMA diameter≥2.95 mm had a higher risk of re-intervention due to T2EL after EVAR.Conclusion AAA patients with risk factors are more likely to require T2EL-related re-intervention after EVAR,while AAA patients whose risk thresholds are higher than the risk threshold of IMA diameter and maximum diameter of the aneurysm body are more likely to require T2EL-related

关 键 词：腹主动脉瘤 腔内修复术 Ⅱ型内漏 危险因素 干预 

分 类 号：R543[医药卫生—心血管疾病]