Outcomes over Time in Patients with Hostile Neck Anatomy Undergoing Endovascular Repair of Abdominal Aortic Aneurysm
Outcomes over Time in Patients with Hostile Neck Anatomy Undergoing Endovascular Repair of Abdominal Aortic Aneurysm
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DOI：
10.1016/j.jvir.2018.03.002
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发表时间：
2018-07-01
影响因子：
2.9
通讯作者：
Samuels, Shaun
中科院分区：
文献类型：
--
作者：
Bryce, Yolanda;Kim, Wonho;Samuels, Shaun
目的：评估接受腹主动脉瘤腔内修复术（EVAR）的不良瘤颈解剖结构患者的早期和晚期结局差异。材料和方法：这项单中心、机构审查委员会批准的回顾性研究评估了2004年至2013年期间接受腹主动脉瘤腔内修复术的患者，分为2个时间段：2004-2008年和2009-2013年。125例患者至少有1项符合入选标准的不良瘤颈参数：早期216例患者中的61例（28%）和晚期144例患者中的64例（44%）。与早期组患者相比，晚期组患者更年轻（晚期组，74.5 ± 8.8岁vs早期组，77.5 ± 7.5岁; P -0.046）。在早期和晚期之间的敌对颈部解剖因素没有观察到显着差异。结果：在围手术期因素或结果的措施，没有观察到统计学差异，除了在晚期腹主动脉瘤（AAA）囊消退相比，早期（晚期，73.5%与早期，55.7%; P = 0.038）。与肾下固定患者相比，在肾上固定晚期组患者中观察到1a型内漏统计学显著增加（肾上，27.0% vs肾下，7.9%; P = 0.025）和研究的总时间（肾上，20.3% vs肾下，7.6%; P = 0.045）。结论：除AAA囊消退外，在接受腹主动脉瘤腔内修复术的敌对瘤颈患者中，未观察到围手术期因素和结局指标随时间的变化。
Purpose: To assess differences in outcome in an early and later time period in patients with hostile neck anatomy who underwent endovascular aneurysm repair (EVAR).Materials and Methods: This single-center, institutional review board-approved retrospective study assessed patients who underwent EVAR between 2004 and 2013, divided into 2 time periods: 2004-2008 and 2009-2013. One hundred twenty-five patients had at least 1 hostile neck parameter that met inclusion criteria: 61 of 216 (28%) patients in the early period and 64 of 144(44%) patients in the late period. Patients in the late group were younger compared to patients in the early group (late group, 74.5 +/- 8.8 years vs early group, 77.5 +/- 7.5 years; P - .046). No significant differences were observed in hostile neck anatomic factors between the early and late periods.Results: No statistical difference was observed in periprocedural factors or outcome measures, except for abdominal aortic aneurysm (AAA) sac regression in the late period compared to the early period (late period, 73.5% vs early period, 55.7%; P = .038). A statistically significant increase was observed in type 1a endoleaks in patients in the late group with suprarenal fixation compared to patients with infrarenal fixation (suprarenal, 27.0% vs infrarenal, 7.9%; P = .025) and in the overall time studied (suprarenal, 20.3% vs infrarenal, 7.6%; P = .045).Conclusions: Except for AAA sac regression, no changes were observed in periprocedural factors and outcome measures over time in patients with hostile neck who underwent EVAR.