Intraoperative sac coiling embolization in type Ⅱ endoleak high-risk population after endovascular aortic repair
10.3760/cma.j.issn.1007-631X.2019.09.001
- VernacularTitle: 术中弹簧圈瘤腔栓塞应用于腹主动脉瘤腔内治疗术后Ⅱ型内漏高危人群的疗效及影响因素分析
- Author:
Xiantao LI
1
;
Yanyan HUANG
1
;
Ruiquan CHEN
2
;
Meihong GUO
3
;
Pingfan GUO
1
Author Information
1. Department of Vascular Surgery, the First Affiliated Hospital of Fujian Medical University, Fuzhou 350004, China
2. Department of Radiology, the First Affiliated Hospital of Fujian Medical University, Fuzhou 350004, China
3. Department of Statistics, Public Health School of Fujian Medical University, Fuzhou 350004, China
- Publication Type:Journal Article
- Keywords:
Aortic aneurysm, abdominal;
Radiology, interventional;
Endoleak;
Risk assessment
- From:
Chinese Journal of General Surgery
2019;34(9):745-749
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the effectiveness and safety of intraoperative sac coiling embolization among patients who are athigh-risk developing type-Ⅱ endoleak after endovascular aortic repair(EVAR).
Methods:From Jan 2014 to Jan 2018, one hundred and twelve consecutive patients with infra-renal AAA were enrolled for this study, There were 76 patients undergoing standard EVAR (standard-group)and 36 patients doing aneurysmal sac coiling embolization (embo-group). Baseline characteristics, aneurysmal sac parameters, radiological intervention details and follow up results were recorded.
Results:Mean follow-up time was 25.9 m for embo-group. During follow-up period, no coils-related complications were noted and no type-Ⅱ endoleak associated secondary interventions were reported. A mean of (2.72±1.16) coils (range 1-7) was used in the embo-group. The incidence of type Ⅱ endoleak was 30.3%(23/76) in standard-group and 11.1%(4/36) in embo-group(χ2=4.90, P=0.027). Logistic multivariate analysis revealed that the independent risk factors of type Ⅱ endoleak after endovascular aortic repair for high-risk patients were those EVAR without sac embolization and sac volume≥128 cm3. In the subgroup analysis (sac volume≥128 cm3), the incidence of type-Ⅱ endoleak was lower in embo-group compared to standard-group (χ2=6.07, P=0.014).
Conclusion:Intraoperative sac coiling embolization in high-risk patients is safe and effective in prevention of type Ⅱ endoleak. This preventive effect is more significant with large sac aneurysm compared to small sac aneurysm.
