Percutaneous closure devices for endovascular repair of infrarenal abdominal aortic aneurysms: A prospective, non-randomized comparative study
Percutaneous closure devices for endovascular repair of infrarenal abdominal aortic aneurysms: A prospective, non-randomized comparative study
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DOI：
10.1016/j.ejvs.2007.10.021
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发表时间：
2008-04-01
影响因子：
5.7
通讯作者：
Batt, M.
中科院分区：
文献类型：
--
作者：
Jean-Baptiste, E.;Hassen-Khodja, R.;Batt, M.
目的.本研究旨在描述和评价我们在腹主动脉瘤（AAA）腔内修复术中使用经皮动脉闭合器械与传统股动脉手术切割的初步结果。材料和方法。2004年1月至2006年12月期间，选择接受腔内修复术的86例AAA患者中有40例符合本研究的入选标准。其中19例患者（A组）通过直接穿刺股动脉（38个股动脉三角）置入分叉覆膜支架，并使用Prostar（R）经皮动脉闭合器械（Abbott）闭合。其他21例患者（对照组B）通过传统开放手术（42个股骨三角）置入分叉覆膜支架进行治疗。前瞻性收集40例患者的相关资料并进行分析。技术成功率为92%（A组）vs 90%（B组），P = 0.79。A组围手术期并发症发生率为16%（3/19），B组为14%（3/21），两组比较差异有统计学意义（P = 0.89）。平均住院时间A组为5.8天，B组为7.8天（P = 0.05）。住院时间的差异与经皮组的成本降低有关（5579.60欧元vs. 7503.60欧元; P = 0.04），这抵消了Prostar XL缝线介导器械引起的成本。两组的平均随访时间为12个月。术后1年局部并发症发生率A组为11%（2/19），B组为19%（4/21）（P = 0.45）。本研究证实了完全经皮腔内AAA修复术的可行性和安全性。我们的初步结果表明，选择性使用经皮闭合器械可能不会增加医疗保健提供者为腹主动脉瘤腔内修复术支付的费用。(C)2007年欧洲血管外科学会。由爱思唯尔有限公司出版。保留所有权利。
Purpose. This study was designed to describe and evaluate our preliminary results with a percutaneous arterial closure device as compared to those obtained with conventional femoral surgical cut down during endovascular repair of abdominal aortic aneurysms (AAA).Material and Methods. Between January 2004 and December 2006, 40 of 86 AAA patients selected for endovascular repair met the criteria for inclusion in this study. Nineteen of these patients (Group A) received a bifurcated endograft placed by direct puncture of the femoral arteries (38 femoral triangles) with closure by a Prostar (R) percutaneous arterial closure device (Abbott). The other 21 patients (control group B) were managed with a bifurcated endograft placed by conventional open surgery (42 femoral triangles). Data concerning all 40 patients were collected prospectively and analyzed.Results. The technical success rate was 92% (group A) vs 90% (group B), P = 0.79. The incidence of perioperative complications was 16% (3/19) in group A and 14% (3/21) in group B (P = 0.89). The mean hospital stay was 5.8 days in group A and 7.8 days in group B (P = 0.05). The difference in the length of hospitalisation was associated with reduced cost for the percutaneous group (5579.60 euros vs. 7503.60 euros; P = 0.04), that counterbalanced the cost induced by the Prostar XL suture mediated device. Mean follow-up in both groups was 12 months. The overall incidence of locoregional complications after one year of follow-up was 11% (2/19) in group A and 19% (4/21) in group B (P = 0.45).Conclusion. This study confirms the feasibility and safety of total percutaneous endovascular AAA repair. Our preliminary results suggest that the costs paid by healthcare providers for endovascular AAA repair might not be increased with the selective use of percutaneous closure devices. (C) 2007 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.