Abdominal aortic aneurysm size regression after endovascular repair is endograft dependent
Abdominal aortic aneurysm size regression after endovascular repair is endograft dependent
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DOI：
10.1067/mva.2003.212
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发表时间：
2003-04-01
影响因子：
4.3
通讯作者：
Makaroun, MS
中科院分区：
文献类型：
--
作者：
Bertges, DJ;Chow, K;Makaroun, MS
目的：本研究旨在确定腹主动脉瘤（AAA）在血管内修复后不同覆膜支架的消退是否不同。对腹主动脉瘤腔内修复术后的尺寸变化进行了四中心回顾性审查。纳入了至少随访1年且有可用影像学检查的连续性患者。390例患者接受了Ancure、AneuRx、Excluder或Talent覆膜支架。在初次术后随访访视以及术后1年和2年时，通过计算机断层扫描（CT）记录AAA尺寸和内漏状态。AAA尺寸定义为二维CT扫描最大轴向切片上肾下主动脉的短轴。AAA尺寸相对于基线的变化≥ 0.5 cm被认为具有临床意义。分析了初始尺寸、内漏和覆膜支架类型对AAA消退的影响。结果：Talent覆膜支架的平均基线尺寸显著较大，Excluder覆膜支架的平均基线尺寸较小。在2年时，近四分之三的Ancure和Talent覆膜支架患者的AAA尺寸发生了具有临床意义的消退。AneuRx（46%）和Excluder（44%）器械的AAA尺寸回归频率较低。初始尺寸、内漏和覆膜支架类型是第1年多变量分析中回归的显著预测因素。然而，到2年时，只有覆膜支架类型仍然是AAA收缩的独立预测因素。动脉瘤腔内修复术后的长期形态学变化取决于覆膜支架类型。
Objective: This study was performed to determine whether abdominal aortic aneurysm (AAA) regression is different with various endografts after endovascular repair.Methods. A four-center retrospective review of size change after endovascular AAA repair was performed. Consecutive patients with at least 1-year follow-up and available imaging studies were included. Three hundred ninety patients received either the Ancure, AneuRx, Excluder, or Talent endograft. AAA size and endoleak status were recorded from computed tomography (CT) scans at the initial postoperative follow-up visit and at I and 2 years thereafter. AAA size was defined as the minor axis of the infrarenal aorta on the largest axial section on the two-dimensional CT scan. A change in AAA size of 0.5 cm or greater from baseline was considered clinically significant. The effect of initial size, endoleak, and type of endograft on AAA regression was analyzed.Results: Mean baseline size was significantly greater with Talent endografts and smaller with Excluder endografts. Clinically significant regression in AAA size occurred in nearly three fourths of patients with Ancure and Talent endografts at 2 years. Regression in AAA size was less frequent with the AneuRx (46%) and Excluder (44%) devices. Initial size, endoleak, and endograft type were significant predictors of regression at multivariate analysis at I year. However, by 2 years only endograft type was still an independent predictor of AAA shrinkage.Conclusions. Long-term morphologic changes after endovascular aneurysm repair depend on endograft type.