Editor's Choice - Type II Endoleak: Conservative Management Is a Safe Strategy
Editor's Choice - Type II Endoleak: Conservative Management Is a Safe Strategy
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DOI：
10.1016/j.ejvs.2014.06.035
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发表时间：
2014-10-01
影响因子：
5.7
通讯作者：
Sayers, R. D.
中科院分区：
文献类型：
--
作者：
Sidloff, D. A.;Gokani, V.;Sayers, R. D.
目的：II型内漏是腹主动脉瘤腔内修补术(EVAR)后最常见的并发症，但其自然病史尚不清楚。这项研究的目的是检查EVAR后单一机构II型内漏的发生率和预后。方法：将1995年9月至2013年7月在单一中心接受EVAR的904名连续患者输入前瞻性数据库。所有患者均行双功能超声(DOSS)随访。结果：共有175例(19%)患者发生II型内漏，平均随访时间为3.6年(1.5-5.9年)；54%的II型内漏在6个月内(0.25-1.2年)自然消退。两组患者在术前人口学特征或植骨选择上无明显差异。II型内渗漏患者的存活率显著较高(94.1%对85.6%；p=.01)，这种影响在晚期II型内渗漏患者中最为明显(97.7%对85.6%p=.004)。两组在动脉瘤相关死亡率和I型内渗漏发生率方面没有差异。在II型内渗漏患者中，囊扩张自由度(距术前直径5 mm)显著降低(82.5%vs.93.2%，p=0.0001)；然而，在距术前直径>；10 mm的阈值下，差异无统计学意义。结论：单纯性II型内渗漏患者表现出与动脉瘤相关的死亡率和存活率的提高。(C)2014年欧洲血管外科学会。爱思唯尔有限公司出版。保留所有权利。
Objective: Type II endoleak is the most common complication after endovascular abdominal aortic aneurysm repair (EVAR); however, its natural history is unclear. The aim of this study was to examine the incidence and outcomes of type II endoleak, at a single institution after EVAR.Methods: A total of 904 consecutive patients who underwent EVAR between September 1995 and July 2013 at a single centre were entered onto a prospective database. All patients were followed up by duplex ultrasound (DUSS). Patients who developed type II endoleak were compared for preoperative demographics, mortality, and sac expansion.Results: A total of 175(19%) patients developed type II endoleak over a median follow-up of 3.6 years (1.5-5.9 years); 54% of type II endoleaks spontaneously resolved within 6 months (0.25-1.2 years). No difference was found in preoperative demographics or choice of endograft between the two groups. Survival was significantly higher in the group with type II endoleak (94.1% vs. 85.6%; p=.01) and this effect was most pronounced in those with late type II endoleaks (97.7% vs. 85.6% p=.004). No difference was seen in aneurysm-related mortality or rate of type I endoleak between the two groups. Freedom from sac expansion (>5 mm from preoperative diameter) was significantly lower in the group of patients with type II endoleak (82.5% vs. 93.2%, p=.0001); however, at a threshold of >10 mm from preoperative diameter no difference was seen.Conclusions: Patients with isolated type II endoleak demonstrate equivalent aneurysm-related mortality and an improved survival. (C) 2014 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.