Endoleak after endovascular graft repair of experimental aortic aneurysms: does coil embolization with angiographic "seal" lower intraaneurysmal pressure?
Endoleak after endovascular graft repair of experimental aortic aneurysms: does coil embolization with angiographic "seal" lower intraaneurysmal pressure?
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实验性主动脉瘤血管内移植修复后的内漏：弹簧圈栓塞与血管造影“密封”是否会降低动脉瘤内压力？
DOI：
10.1016/s0741-5214(98)70320-9
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发表时间：
1998
影响因子：
4.3
通讯作者：
Veith,FJ
中科院分区：
文献类型：
--
作者：
Marty,B;Sanchez,LA;Ohki,T;Wain,RA;Faries,PL;Cynamon,J;Marin,ML;Veith,FJ
目的探讨内漏与动脉瘤内压（IAP）的关系及弹簧圈栓塞治疗内漏的效果。方法将犬肾下主动脉（n = 15）用含压力传感器的聚四氟乙烯动脉瘤替代。组I（n = 4）有未经治疗的动脉瘤。第II组（n = 4）的动脉瘤经血管内排除，无内漏。第III组（n = 7）的动脉瘤通过植入物排除，植入物存在代表内漏来源的缺损。在4周的随访研究后，对第III组犬的内漏进行弹簧圈栓塞。每天测量收缩压IAP，并表示为从前肢袖带获得的收缩压的比率。动脉造影，双功超声，螺旋造影计算机断层扫描进行评估endoleaks.ResultsIn组I，IAP仍然接近收缩压（0.96 ± 0.06的比率），而在组II的IAP比显示下降到0.34 ± 0.16（P = 0.0009组I与II）。在初始降低后，第III组的IAP比值稳定在0.75 ± 0.18（p = 0.003，第II组与第III组）。有内漏的动脉瘤保持搏动，脉压为30 ± 16 mm Hg，低于未治疗的动脉瘤（62 ± 15 mm Hg; p < 0.0001，第I组与第III组）。动脉造影和计算机断层扫描显示“密封”的内漏后，线圈embolization，但IAP比并没有减少（0.76 ± 0.14）线圈embolization.ConclusionsIncomplete血管内动脉瘤隔绝术引起的内漏未能减少IAP比，并可能受到动脉瘤破裂的持续风险。虽然弹簧圈栓塞导致血管造影和计算机断层扫描凝闭，但未能降低IAP比率。（J Vasc Surg 1998;27：454-62.）
PurposeTo investigate the relation between endoleaks and intraaneurysmal pressure (IAP) and the effect of coil embolization in the management of endoleaks.MethodsThe infrarenal aorta of a dog (n = 15) was replaced by a polytetrafluoroethylene aneurysm containing a pressure transducer. Group I (n = 4) had untreated aneurysms. Group II (n = 4) had endovascularly excluded aneurysms without an endoleak. Group III (n = 7) had aneurysms excluded by means of grafts with a defect that represented the source of an endoleak. After 4 weeks of follow-up study, the endoleaks in group III dogs were subjected to coil embolization. Systolic IAP was measured daily and expressed as a ratio of systolic blood pressure obtained from a forelimb cuff. Arteriography, duplex ultrasonography, and spiral contrast computed tomography were performed to evaluate endoleaks.ResultsIn group I, the IAP remained close to systolic blood pressure (ratio of 0.96 ± 0.06), whereas in group II the IAP ratio showed a decline to 0.34 ± 0.16 (p = 0.0009 group I versus II). After an initial decrease, the IAP ratio in group III stabilized at 0.75 ± 0.18 (p = 0.003, group II versus III). Aneurysms with an endoleak remained pulsatile with a pulse pressure of 30 ± 16 mm Hg, which was less than that of untreated aneurysms (62 ± 15 mm Hg; p < 0.0001 group I versus III). Arteriography and computed tomography revealed "sealing" of endoleaks after coil embolization, but IAP ratio did not decrease (0.76 ± 0.14) after coil embolization.ConclusionsIncomplete endovascular aneurysm exclusion caused by an endoleak fails to reduce IAP ratio and may subject the aneurysm to a continued risk for rupture. Although coil embolization resulted in angiographic and computed tomographic sealing, it failed to reduce IAP ratio. (J Vasc Surg 1998;27:454-62.)