Aortic banding for refractory endoleaks after endovascular abdominal aortic aneurysm repair
10.3760/cma.j.cn113855-20221104-00683
- VernacularTitle:瘤颈捆扎治疗腹主动脉瘤腔内修复术后持续内漏的疗效分析
- Author:
Weihao LI
1
;
Xuemin ZHANG
;
Tao ZHANG
;
Jing LI
;
Xiaoming ZHANG
Author Information
1. 北京大学人民医院血管外科，北京 100044
- Keywords:
Aortic aneurysm, abdominal;
Surgical procedures,operative;
Endoleak;
Aortic banding
- From:
Chinese Journal of General Surgery
2023;38(3):178-182
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To summarize the safety and efficacy of aortic banding in the treatment of refractory endoleaks after endovascular abdominal aortic aneurysm repair (EVAR).Methods:The clinical and follow-up data of 10 patients with refractory endoleaks EVAR undergoing aortic banding at Peking University People's Hospital from Jun 2019 to Aprl 2022 were retrospectively analyzed.Results:The aortic banding was indicated for type Ⅰ endoleak in 6 patients, type Ⅱ endoleak in 3 patients and internal tension in 1 patient with persistent aneurysm enlargement or rupture. The surgical procedure was based on laparotomy. The proximal aortic neck was exposed and re-fixation with artificial strip to prevent bleeding. The surgical procedures was successful in all the 10 cases without residual endoleak or re-bleeding. The post-operative contrast-enhanced ultrasonography revealed neither new-onset endoleak nor occlusion of stent-grafts. Perioperative complications included one case of delayed wound healing and one case of incomplete ileus. No perioperative deaths occurred. Midterm follow-up was achieved in 10 patients with a mean follow-up time of 13 months. No recurrence of endoleak was found. One patient underwent endovascular repair for independent thoracic aortic aneurysm 6 months after surgery. There were no other aorta-related secondary surgeries or aortic-related deaths.Conclusion:Aortic banding for refractory endoleaks after EVAR is minimally invasive and reliable. It can effectively eliminate the refractory endoleaks, and reduce the risks of aortic-related secondary surgery or death.
