Amplatzer Vascular Plug to occlude the internal iliac arteries in patients undergoing aortoiliac aneurysm repair
Amplatzer Vascular Plug to occlude the internal iliac arteries in patients undergoing aortoiliac aneurysm repair
复制标题
DOI：
10.1016/j.jvs.2005.08.017
复制
发表时间：
2005-12-01
影响因子：
4.3
通讯作者：
Calcagno, D
中科院分区：
文献类型：
--
作者：
Ha, CD;Calcagno, D
目的：本报告的目的是评估常规线圈和Amplatzer血管塞（一种镍钛诺基自膨胀装置）在髂主动脉瘤或髂普通动脉瘤内植修复患者中闭塞髂内动脉的应用。2004年8月至12月间，在一家社区医院系统中，为了准备髂主动脉瘤或髂总动脉瘤或两者的内移植术，5名患者接受了Amplatzer血管栓塞术来封堵髂内动脉，以防止内漏。在此之前的12个月中，有10例患者采用了传统的髂内动脉线圈栓塞术。在5例接受Amplatzer血管塞闭塞髂内动脉的患者中，在动脉起源处实现了精确的部署。血管造影证实完全和精确的闭塞，每条髂内动脉只使用一个装置。2例患者在术后2周出现轻度臀部跛行，分别在术后6周和8周完全消失。1例患者发生肠系膜下动脉II型内漏。在之前的10例患者中，11条髂内动脉采用常规线圈治疗。3例患者需要重复线圈栓塞。第二组手术并发症包括1例线圈栓塞入股浅动脉，1例栓塞入髂总动脉；通过血管内技术成功回收了两个错误的线圈。每条髂内动脉平均使用7 +/- 3.4（5的模式）线圈。本组单侧髂内动脉闭塞后出现3例臀部跛行，均未痊愈。两组均未发现缺血性肠、臀部坏死或性功能障碍。Amplatzer血管塞闭塞一条髂内动脉的平均费用估计为375美元，而传统线圈的平均费用为3500美元。Amplatzer血管塞是一种经济有效的方法，可以在接受髂主动脉动脉瘤内移植修复的患者中闭塞髂内动脉，使用单一装置在动脉起源处精确放置，最大限度地降低了成本，避免了缺血性并发症。[j] .中华外科杂志2005；42。
Purpose: The purpose of this report is to evaluate the use of conventional coils and the Amplatzer Vascular Plug, a type of nitinol-based self-expanding device, to occlude the internal iliac artery in patients undergoing aortoiliac or common iliac aneurysm endograft repair, or both.Methods. Between August and December 2004, in preparation for endograft repairs of aortoiliac or common iliac artery aneurysms, or both, at a community hospital system, five patients underwent the occlusion of the internal iliac artery with an Amplatzer Vascular Plug to prevent endoleak. During the preceding 12 months, the conventional coil embolization of the internal iliac artery was used for the same purpose in 10 patients.Results. In five patients undergoing the Amplatzer Vascular Plug occlusion of the internal iliac artery, precise deployment at the origin of the artery was achieved. Complete and precise occlusion was confirmed angiographically, and only one device was used for each internal iliac artery. Two patients reported mild buttock claudication 2 weeks after occlusion, which resolved completely by 6 and 8 weeks, respectively. A type II endoleak from the inferior mesenteric artery developed in one patient. In the previous 10 patients, 11 internal iliac arteries were treated with conventional coils. Subsequent repeat coil embolization was required for three patients. The procedural complications in this second group included one case of coil embolization into the superficial femoral artery and one into the common iliac artery; both errant coils were retrieved successfully by endovascular techniques. An average of 7 +/- 3.4 (mode of 5) coils were used for each internal iliac artery. Three cases of buttock claudication occurred after the unilateral internal iliac artery occlusion in this group and did not resolve. No evidence of ischemic bowel, buttock necrosis, or sexual dysfunction was observed in either group. The estimated average cost to occlude one internal iliac artery was $375 for Amplatzer Vascular Plugs and $3,500 for conventional coils.Conclusions. The Amplatzer Vascular Plug allows for a cost-effective method to occlude the internal iliac artery in patients undergoing endograft repairs of aortoiliac aneurysms, The use of a single device with a precise placement at the origin of the artery minimizes cost and avoids ischemic complications. (j Vase Surg 2005;42).