髂动脉瘤腔内治疗应用髂动脉分支装置保留髂内动脉的单中心疗效分析  

Analysis of endovascular treatment for iliac artery aneurysms using iliac branch devices to preserve the internal iliac artery:A single-center study

作　　者：冯霖 邱涛 张智辉[1] 林少芒[1] 艾文佳[1] 李强[1] 陈松伟[1] 李阳勇[1] 李国林 蔡欢 范修锦 汪健祥 萧剑彬[1] Feng Lin;Qiu Tao;Zhang Zhihui;Lin Shaomang;Ai Wenjia;Li Qiang;Chen Songwei;Li Yangyong;Li Guolin;Cai Huan;Fan Xiujin;Wang Jianxiang;Xiao Jianbin(Department of Vascular Surgery,The Second Affiliated Hospital of Guangzhou Medical University,Guangzhou 510260,Guangdong,China)

机构地区：[1]广州医科大学附属第二医院血管外科,广东广州510260

出　　处：《中国血管外科杂志(电子版)》2025年第1期50-54,共5页Chinese Journal of Vascular Surgery(Electronic Version)

基　　金：广东省医学科研基金项目(B2024051);广州地区临床高新和重大技术项目(2024C-ZD23)。

摘　　要：目的分析髂动脉瘤腔内治疗应用髂动脉分支装置(iliac branch device,IBD)保留髂内动脉的临床疗效及安全性。方法回顾性分析2019年12月至2024年2月在广州医科大学附属第二医院行IBD腔内治疗的20例髂动脉瘤患者(22条髂动脉)临床资料,评估其技术成功率、早期疗效及安全性。结果手术技术成功率为100%,手术时间为(197.50±51.62)min。20例患者共植入IBD 22例次,其中EXCLUDER支架16例次,G-iliacTM支架2例次,自制IBD 4例次。3例患者发生术后即刻Ⅱ型内漏。患者随访时间为3.50(1.00,5.88)个月,随访期间IBD主体通畅率及髂内动脉支架一期通畅率均为100%,无内漏和支架相关并发症发生。2例患者接受再干预治疗,无盆腔缺血、性功能障碍等情况发生。术后患者腹主动脉、髂总动脉、髂内动脉最大直径均较术前呈缩小趋势,瘤囊均处于稳定或缩小状态。结论在髂动脉瘤的腔内治疗中,IBD技术能保留至少一侧髂内动脉,具有良好的早期疗效及安全性。Objective To analyze the clinical efficacy and safety of endovascular treatment for iliac artery aneurysms using iliac branch devices(IBDs)to preserve the internal iliac artery.Methods The clinical data of 20 patients(22 iliac arteries)who underwent endovascular treatment with IBD for iliac artery aneurysm at the Second Affiliated Hospital of Guangzhou Medical University from December 2019 to February 2024 were analyzed retrospectively.The technical success rate,early efficacy and safety were assessed.Results The technical success rate was 100%,with an average operative time of 197.50±51.62 minutes.A total of 22 IBDs were implanted,including 16 EXCLUDER stents,two G-iliacTM stents and four custom-made IBDs.Three patients had immediate postoperative typeⅡendoleak.The median follow-up period was 3.50(1.00,5.88)months.During follow-up,both the primary patency rate of IBDs and the internal iliac artery stent were 100%,with no endoleaks or stent-related complications.The maximum diameters of the abdominal aorta,common iliac artery,and internal iliac artery showed a general trend of reduction postoperatively,and all aneurysm sacs remained stable or decreased in size.Conclusion In the endovascular treatment of iliac artery aneurysms,the IBDs technique is able to preserve at least one side of the internal iliac artery,with favorable early efficacy and safety.

关 键 词：髂动脉瘤 髂动脉分支装置 重建 髂内动脉 

分 类 号：R654.3[医药卫生—外科学]