G-iliac^(TM)髂动脉分叉支架系统重建髂内动脉的单中心疗效分析  

Single-center analysis of the outcomes of the internal iliac artery revascularization with G-iliac^(TM) iliac artery bifurcation stent graft system

作　　者：陈威敏 黄扬杰 何天敏[1] 吴捷[3] 戴贻权[1] 郭平凡[1] 蔡方刚[1] Chen Weimin;Huang Yangjie;He Tianmin;Wu Jie;Dai Yiquan;Guo Pingfan;Cai Fanggang(Department of Vascular Surgery,The First Affiliated Hospital of Fujian Medical University,Fuzhou 350005,China;Department of Vascular Surgery,Sanming Second Hospital,Yong'an 353000,China;National Regional Medical Center,Binhai Campus of the First Affiliated Hospital of Fujian Medical University,Fuzhou 350212,China)

机构地区：[1]福建医科大学附属第一医院血管外科,福州350005 [2]三明市第二医院血管外科,福建永安353000 [3]福建医科大学附属第一医院滨海院区国家区域医疗中心,福州350212

出　　处：《中华血管外科杂志》2024年第5期308-312,共5页Chinese Journal of Vascular Surgery

摘　　要：目的总结分析单中心应用G-iliacTM髂动脉分叉支架系统重建髂内动脉血运的临床疗效。方法本研究为回顾性纵向研究。回顾性分析2021年3月至2024年6月福建医科大学附属第一医院血管外科行腹主-髂动脉瘤血管腔内治疗的24例患者的临床资料。手术均应用G-iliacTM髂动脉分叉支架系统完成髂内动脉血运重建。24例患者均为男性, 年龄(69.5±8.0)岁;包括腹主动脉瘤合并双侧髂总动脉瘤16例, 腹主动脉瘤合并双侧髂内动脉瘤2例, 腹主动脉-右髂总、双髂内动脉动脉瘤1例, 双侧孤立性髂总动脉瘤 5例。髂总动脉瘤直径(32.5±7.2)mm(范围:21.3~43.5 mm)。观察手术结果和随访结果, 评估髂内动脉支架的通畅情况、瘤体的大小变化及内漏发生率等。结果 24例患者中, 22例(91.7%)成功完成手术, 均为单侧髂内动脉重建, 左右侧髂内动脉各11例;应用SilverFlow髂内动脉覆膜支架20例, Lifestream球扩式覆膜支架2例。2例失败均与超选髂内动脉失败有关。22例手术成功患者均获得随访数据, 随访时间为(14.2±10.3)个月(范围:1.0~36.0个月)。随访期内, 髂分支支架闭塞1例, 髂总动脉瘤直径术后缩小(5.5±5.4)mm(范围:0~17.5 mm), 1例腹主动脉瘤有Ⅱ型内漏。髂动脉瘤未见内漏与瘤体增大, 无二次手术干预, 髂分支支架无断裂与移位等。结论腹主动脉瘤腔内修复术中应用G-iliacTM髂动脉分叉支架系统重建髂内动脉血运, 早期疗效良好。Objective:To summarize and analyze the outcomes of the revascularization of the internal iliac artery with G-iliac^(TM) iliac artery bifurcation stent graft system based on a single-center experience.Methods:In this retrospective longitudinal study,the clinical data of 24 patients who underwent endovascular aortic repair(EVAR)for treating abdominal aorto-iliac aneurysms at the Department of Vascular Surgery,the First Affiliated Hospital of Fujian Medical University from March 2021 to June 2024 were analyzed.The G-iliac^(TM) system was used for internal iliac artery revascularization in all cases.Among the 24 patients,16 were with abdominal aortic aneurysm(AAA)combined with bilateral common iliac artery aneurysm(CIAA);2 were with AAA combined with bilateral internal iliac artery aneurysm(IIAA);1 was with AAA,right CIAA and bilateral IIAA;and 5 were with isolated bilateral CIAA.The average diameter of the CIAA was 32.5±7.2 mm(21.3-43.5 mm).The surgical and follow-up results were observed,with the evaluation of the patency of the internal iliac artery stent,changes in aneurysm size,and the incidence of endoleak.Results:(1)All the 24 patients were males and aged(69.5±8.0)years.Among them,22(91.7%)successfully completed surgeries with unilateral internal iliac artery revascularization(11 patients on each side).SilverFlow^(TM) Iliac Stent Graft was applied in 20 patients,while LifeStream^(TM) Balloon Expandable Vascular Covered Stent Graft in 2 patients.There were 2 failures,which were both related to the failure of superselection of the internal iliac artery.(2)The 22 patients who had successful completed surgery were all followed up for an average duration of 14.2±10.3 months(1-36 months).During the follow-up,there was 1 patient with iliac branch stent occlusion and the diameter of CIAA decreased by 5.5±5.4 mm(0-17.5 mm).The typeⅡendoleak at AAA was found 1 one case,while no endoleak or aneurysm enlargement were found in iliac artery aneurysm.There were also no secondary surgical interventions and no fractures

关 键 词：腹主动脉瘤 腔内治疗 髂内动脉 髂动脉瘤 髂动脉分支支架 

分 类 号：R65[医药卫生—外科学]