Snorkel endovascular abdominal aortic aneurysm repair versus fenestrated endovascular aneurysm repair: is it a competition?
Snorkel endovascular abdominal aortic aneurysm repair versus fenestrated endovascular aneurysm repair: is it a competition?
复制标题
呼吸管腹主动脉瘤血管内修复术与开窗血管内动脉瘤修复术：这是一场竞争吗？
DOI：
10.1053/j.semvascsurg.2016.07.002
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发表时间：
2016
影响因子：
2.5
通讯作者：
M. Shames
中科院分区：
文献类型：
--
作者：
A. Tanious;Jason T. Lee;M. Shames
肾近腹主动脉瘤 (AAA) 的血管内治疗可以通过标准血管内覆膜支架与主动脉分支上的附加通气管移植物（通气管血管内动脉瘤修复）或植入有孔支架移植物（有孔血管内动脉瘤修复）来进行。虽然许多血管外科医生认为通气管血管内动脉瘤修复和开窗血管内动脉瘤修复是竞争技术或替代策略，但已发表的手术结果表明更多的互补作用。在这篇临床综述中，对这两种方法的优缺点进行了争论，因为可以从这两种策略中学到很多东西。由于近肾 AAA 修复的适应症和情况因患者特定的合并症和解剖结构而异，因此建议血管外科医生能够获得并体验这两种治疗策略。根据已发表的结果，与开放性 AAA 修复相比，患者结果、支架移植物通畅率和再干预率通常相似且可以接受。我们的结论是，对于近肾和肾旁 AAA 解剖结构的血管内治疗，通气管血管内动脉瘤修复和开窗血管内动脉瘤修复都有时间和地点。
The endovascular treatment of juxtarenal abdominal aortic aneurysm (AAA) can be performed by either a standard endovascular stent graft with additional snorkle grafts to aorta branches (snorkel endovascular aneurysm repair) or implantation of a fenestrated stent graft (fenestrated endovascular aneurysm repair). While many vascular surgeons consider snorkel endovascular aneurysm repair and fenestrated endovascular aneurysm repair to be competing techniques or alternate strategies, published procedural outcomes suggest more complementary roles. In this clinical review, the advantages and disadvantages of these two approaches are debated, as much can be learned from both strategies. Because the indications and circumstances for juxtarenal AAA repair vary based on patient-specific comorbidities and anatomy, it is recommended that vascular surgeons have access to, and experience with, both treatment strategies. Based on published outcomes, patient outcomes, stent-graft patency, and re-intervention rates are generally similar and acceptable compared with open AAA repair. We conclude that there is a time and a place for both snorkel endovascular aneurysm repair and fenestrated endovascular aneurysm repair for the endovascular management of juxtarenal and pararenal AAA anatomy.