Fibrin Glue Sac Filling for Preventing Type II Endoleak, Short-Term Outcomes of a Prospective Randomized Controlled Trial.

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY

Accounts of Chemical Research Pub Date : 2024-10-01 Epub Date: 2023-03-21 DOI:10.1177/15266028231159245

Yonghui Chen, Lei Zhang, Zongwei Liu, Jiaxue Bi, Fang Niu, Xiaoxing Zhang, Qingsheng Lu, Xiangchen Dai

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引用次数: 0

Abstract

Objective: Type II endoleak (T2EL) worsens the long-term results of endovascular aneurysm repair (EVAR). How to prevent T2ELs remains controversial. This study aimed to evaluate the efficacy and safety of fibrin glue sac filling (FGSF) to prevent T2ELs after EVAR.

Methods: A prospective randomized controlled trial was conducted. Patients were randomly divided into group A (standard EVAR + FGSF) and group B (standard EVAR). The follow-up plans included outpatient or telephone consultation at 1 and 3 months and computed tomography (CT) angiography at 6 months, 1 year, and once a year after EVAR.

Results: A total of 64 abdominal aortic aneurysm (AAA) patients were randomized to the 2 groups. All patients were followed up for more than 6 months. The 2 groups showed similar baseline characteristics. The rate of T2ELs on immediate angiography in group A (9.6%) was significantly lower than that in group B (33.3%, p=0.033). Moreover, the sac area change was significantly reduced in group A at 6 months after EVAR (p=0.021). However, T2EL incidence was similar at the 6-month (p=0.055) and 1-year (p=0.057) follow-ups, and AAA diameter change was also similar at 1 year. There were similar operation times, radiation doses, severe adverse events (SAEs), and reinterventions between the 2 groups.

Conclusion: Fibrin glue sac filling could prevent short-term type II endoleaks and promote AAA shrinkage after 6 months. The FGSF procedure is swift and straightforward; however, patients are at risk of bowel ischemia, especially after previous bowel resections or concomitant superior mesenteric artery (SMA) disease.

Clinical impact: Standard endovascular aneurysm repair (EVAR) couldn't prevent type II endoleak (T2EL). In this study, we found fibrin glue sac filling (FGSF) could prevent T2EL and promote AAA shrinkage in a short term. And the FGSF procedure is easy, it will be a useful supplement to standard EVAR for clinicians. And FGSF might have potential usefulness on ruptured aneurysms, although without direct evidence.Fibrin glue is often used to hemostasis and tissue adhesion in surgical patients and burn patients, we firstly carry out a randomized controlled study and prove that fibrin glue sac filling could prevent T2EL and promote sac remodeling.

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纤维蛋白胶囊填充预防 II 型内渗漏，一项前瞻性随机对照试验的短期结果。

目的：II型内漏（T2EL）会恶化血管内动脉瘤修补术（EVAR）的长期效果。如何预防 T2EL 仍存在争议。本研究旨在评估纤维蛋白胶囊填充（FGSF）预防 EVAR 术后 T2EL 的有效性和安全性：方法：进行了一项前瞻性随机对照试验。患者被随机分为 A 组（标准 EVAR + FGSF）和 B 组（标准 EVAR）。随访计划包括 EVAR 后 1 个月和 3 个月的门诊或电话咨询，以及 6 个月、1 年和 1 年一次的计算机断层扫描（CT）血管造影：共有64名腹主动脉瘤（AAA）患者被随机分为两组。所有患者均接受了6个月以上的随访。两组患者的基线特征相似。A 组的即时血管造影 T2EL 率（9.6%）明显低于 B 组（33.3%，P=0.033）。此外，EVAR术后6个月时，A组的囊面积变化明显减少（P=0.021）。然而，6个月随访（p=0.055）和1年随访（p=0.057）时的T2EL发生率相似，1年时的AAA直径变化也相似。两组患者的手术时间、放射剂量、严重不良事件（SAE）和再干预情况相似：结论：纤维蛋白胶囊填充术可预防短期的II型内漏，并在6个月后促进AAA收缩。结论：纤维蛋白胶囊填充术可防止短期内的 II 型内漏，并在 6 个月后促进 AAA 收缩。纤维蛋白胶囊填充术快速、简便，但患者有肠道缺血的风险，尤其是既往接受过肠道切除术或同时患有肠系膜上动脉（SMA）疾病的患者：临床影响：标准的血管内动脉瘤修补术（EVAR）无法预防II型内漏（T2EL）。在这项研究中，我们发现纤维蛋白胶囊填充术（FGSF）可在短期内预防 T2EL 并促进 AAA 收缩。而且 FGSF 操作简单，对临床医生来说是标准 EVAR 的有益补充。纤维蛋白胶常用于手术患者和烧伤患者的止血和组织粘连，我们首次开展了一项随机对照研究，证明纤维蛋白胶囊填充可预防 T2EL 并促进囊重塑。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.