The effect of thrombin in preventing endoleaks and promoting sac regression after endovascular repair of abdominal aortic aneurysm
10.3760/cma.j.cn113855-20240118-00047
- VernacularTitle:凝血酶在预防腹主动脉瘤腔内修复术后内漏及促进瘤囊回缩中的作用
- Author:
Shilu ZHAO
1
;
Jingyuan LUAN
;
Qichen FENG
;
Jinman ZHUANG
Author Information
1. 北京大学第三医院介入血管外科，北京 100191
- Keywords:
Aortic aneurysm,abdominal;
Thrombin;
Endovascular repair;
Endoleak
- From:
Chinese Journal of General Surgery
2024;39(11):850-854
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the effect of thrombin in preventing endoleaks and promoting sac regression after endovascular repair of abdominal aortic aneurysm.Methods:Retrospective study was performed on patients with abdominal aortic aneurysm (AAA) who were admitted to Peking University Third Hospital for endovascular repair (EVAR) from May 2018 to May 2023. Thrombin injection was performed during EVAR in patients with high risk of endoleaks, and the success rate of the operation, perioperative mortality (30 d), incidence of endoleak, thrombin-related allergic reactions and ectopic embolism were observed.Results:In 83 patients, the technical success rate was 100% (83/83). The average operation time was (89.9±17.1) min. The average hospitalization was (5.8±1.3) days. There were no thrombin-related allergic reactions and ectopic embolism in peri-operation. The median follow-up time was 36 months. Five patients lost follow-up. During the follow-up period, 3 patients died, of which 2 died of acute myocardial infarction at 16 and 24 months, respectively, and 1 died of lung cancer at 34 months. The remaining 75 patients survived, with an overall survival rate of 96.2% (75/78). Type Ⅱ internal leakage occurred in 3 of the 75 patients, with an incidence of 4.0%. The maximum diameter and volume of the sac did not increase significantly during follow-up, and conservative treatment was performed. The mean maximum sac diameter of 75 patients was (43.8±7.4) mm, which was significantly lower than that of (61.4±14.4) mm before EVAR ( P<0.001). The sac volume was also significantly decreased [(125.5±54.1) cm 3vs. (239.3±145.1) cm 3, P<0.01]. Conclusions:The use of thrombin in the prevention and treatment of endoleak during EVAR is safe and effective after mid-term follow-up. In the follow-up of EVAR, attention should be paid to the change of sac volume.
