A comparative study of the bell-bottom technique vs hypogastric exclusion for the treatment of aneurysmal extension to the iliac bifurcation.
A comparative study of the bell-bottom technique vs hypogastric exclusion for the treatment of aneurysmal extension to the iliac bifurcation.
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DOI：
10.1016/j.jvs.2011.10.121
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发表时间：
2012-04
影响因子：
4.3
通讯作者：
Eskandari, Mark K.
中科院分区：
文献类型：
--
作者：
Naughton, Peter A.;Park, Michael S.;Kheirelseid, Elrasheid A. H.;O'Neill, Sean M.;Rodriguez, Heron E.;Morasch, Mark D.;Madhavan, Prakash;Eskandari, Mark K.
在接受血管内动脉瘤修复术（EVAR）的患者中，有相当大比例的患者存在常见的髂动脉动脉瘤（CIAA）。髂分叉处的动脉瘤受累可能会破坏其长期耐久性。在两所教学医院中发现了在CIAA下行EVAR的患者。采用钟底技术（髂肢体≥20mm） （BBT）或髂内动脉栓塞+肢体延伸至髂外动脉（IIE+EE）。比较了两种方法的效果。185名患者被确诊。EVAR的适应症包括无症状AAA（157例）、有症状或破裂的动脉瘤（19例）和髂总动脉瘤（9例）。平均AAA直径59 mm。共治疗260例大型cia。166条CIAA肢体行BBT治疗，94条肢体行IIE+EE治疗。BBT组（n=19, 11%）和IIE+EE组（n=18, 19.1%）的总再干预率相似（p=0.149）。据报道，1b型或3型内漏的再干预率相似，BBT （n= 7.4%）与IIE+EE (n= 4.4%) （p=1.0）。两组间肢体通畅率无显著性差异。30天死亡率为1%。中位随访时间为22个月。虽然两组之间的并发症无显著差异，但IIE+EE组围手术期并发症和再干预的总发生率更高（49%比22%，p-0.002）。与BB技术相比，IIE+EE的围手术期并发症和再干预的综合发生率明显更高。因此，在可行的情况下，BB是可取的。
A significant proportion of patients undergoing endovascular aneurysm repair (EVAR) have common iliac artery aneurysms (CIAA). Aneurysmal involvement at the iliac bifurcation potentially undermines long-term durability. Patients who underwent EVAR with CIAA were identified in two teaching hospitals. Bell-bottom technique (iliac limb ≥ 20mm) (BBT) or internal iliac artery embolization and limb extension to the external iliac artery (IIE+EE) were used. Outcome between these two approaches are compared. One hundred and eighty five patients were identified. . Indication for EVAR included asymptomatic AAA (n=157), symptomatic or ruptured aneurysm (n=19), and common iliac artery aneurysm (n=9). Mean AAA diameter was 59 mm. A total of 260 large CIAAs were treated. One hundred and sixty six CIAA limbs were treated with BBT, 94 limbs underwent IIE+EE. Total reintervention rates were similar for BBT (n=19, 11%) and IIE+EE (n=18, 19.1%) (p=0.149). Similar rates of reintervention for type 1b or 3 endoleak are reported, BBT (n=7, 4%) versus IIE+EE (n=4, 4%) (p=1.0). There was no significant difference in limb patency rates. Thirty-day mortality was 1%. Median follow-up was 22 months. While there was no significant difference in complications between the two groups the combined incidence of perioperative complications and reinterventions was higher in the IIE+EE group (49% versus 22%, p-0.002). The combined incidence of perioperative complications and reinterventions is significantly higher in the IIE+EE when compared with the BB technique. Therefore, when feasible, BB is desirable..
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影响因子：
3.8
作者：
Ballotta, Enzo;Da Giau, Giuseppe;Toniato, Antonio
通讯作者：
Toniato, Antonio
影响因子：
2.9
作者：
Bratby, M. J.;Munneke, G. M.;Morgan, R. A.
通讯作者：
Morgan, R. A.
DOI：
10.1016/j.jamcollsurg.2006.01.005
发表时间：
2006-04-01
影响因子：
5.2
作者：
Bush, RL;Johnson, ML;Ashton, CM
通讯作者：
Ashton, CM
影响因子：
4.3
作者：
Kritpracha, B;Pigott, JP;Beebe, HG
通讯作者：
Beebe, HG
影响因子：
4.3
作者：
Matsumura, JS;Pearce, WH;Yao, JST
通讯作者：
Yao, JST