SURGICAL-MANAGEMENT OF COMPLICATIONS FOLLOWING ENDOLUMINAL GRAFTING OF ABDOMINAL AORTIC-ANEURYSMS
SURGICAL-MANAGEMENT OF COMPLICATIONS FOLLOWING ENDOLUMINAL GRAFTING OF ABDOMINAL AORTIC-ANEURYSMS
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DOI：
10.1016/s1078-5884(05)80198-4
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发表时间：
1995-07-01
影响因子：
5.7
通讯作者：
HARRIS, JP
中科院分区：
文献类型：
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作者：
MAY, J;WHITE, GH;HARRIS, JP
目的：报告腹主动脉瘤（AAA）腔内移植术的预后，并特别注意并发症。方法：1992年5月至1994年8月对61例动脉瘤患者行腔内修复术。53例动脉瘤是主动脉瘤这是本报告的基础。在AAA患者中，所有的手术都是反射的，并且在手术室中进行，如果肠内修复失败，患者将被覆盖以进行开放式修复。内移植物的结构为管状36根，锥形髂主动脉/股主动脉12根，分叉5根。利用x线引导将内移植物通过股动脉或髂动脉引入的输送鞘进入主动脉。结果：53例患者中有43例（81%）成功完成了AAA腔内修复。在剩下的10例患者中，放弃了腔内修复而选择开放修复。有17例（32%）局部/血管并发症和13例（25%）全身/远处并发症。这些并发症发生在成功的腔内修复和导致腔内修复失败的并发症的总和为40（75%）。在接受腔内修复的患者中，30天内有2例心脏死亡（均与手术相关），4例晚期死亡（与动脉瘤修复无关）。晚期死亡患者中有3例为腔内修复，1例为腔内转开修复。结论：经腹主动脉腔内修复术围手术期（< 30天）死亡率低（3.7%），但发病率高（75%）。建议将并发症分为三组：系统/远端和局部/血管（在腔内修复成功后）加上导致腔内修复失败的并发症。第一组由内科并发症组成，后两组由与腔内技术直接相关的外科并发症组成。
Objective: The aim of this study was to report the outcome of endoluminal grafting of abdominal aortic aneurysyms (AAA) with special reference to complications.Methods: Between May 1992 and August 1994 endoluminal repair of aneurysms was undertaken in 61 patients. In 53 the aneurysm was aortic and these are the basis of this report. In patients with AAA all procedures were rlective and were performed in the operating room with the patient draped for an open repair in the event of failed endoluminal repair. The configuration of the endografts tons tubular 36, tapered aortoiliac/aortofemoral 12 and bifurcated 5. Radiographic guidance was used to pass the endografts into the aorta via a delivery sheath introduced through the femoral or iliac arteries.Results: Successful endoluminal repair of AAA was achieved in 43 of 53(81%) patients. In the remaining 10 patients, endoluminal repair was abandoned in favour of an open repair There were 17(32%) local/vascular and 13(25%) systemic/ remote complications. The sum of these complications occurring in successful endoluminal repairs and those complications leading to failure of endoluminal repair teas 40(75%). There were two cardiac deaths within 30 days in patients undergoing endoluminal repair (both procedure related) and four late deaths (unrelated to aneurysm repair). Three of the late deaths were in patients undergoing endoluminal repair and one endoluminal converted to open repair.Conclusion: Endoluminal repair of AAA in our experience has a low perioperative (< 30 days) mortality rate (3.7%) but a high morbidity rate (75%). It is recommended that complications be classified into three groups: systemic/remote and local/vascular (following successful endoluminal repair) plus those complications lending to failure of endoluminal repair The first group is composed of medical complications while the latter two groups comprise those surgical complications directly related to the endoluminal technique.