不同类型支架移植在血管内腹主动脉瘤修复中的效果:哥伦比亚一个高复杂性中心的长期经验,拉丁美洲的第一个例子

Douglas Cáceres Castrillón, Ruddy Guzmán Gutiérrez, Romeo Guevara Rodríguez, David Gómez Garnica, I. D. Lozada Martínez, L. F. Cabrera Vargas
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摘要

在5年随访中,血管内腹主动脉瘤修复(EVAR)装置与较高的并发症发生率相关。在10年随访中,至少30%的EVAR患者需要某种类型的再干预(无论是血管内的还是开放的)。这些并发症包括内漏、腹主动脉瘤破裂、移植物迁移、闭塞或感染。本文的目的是确定在我们当地人群中使用的每种EVAR支架移植物的失败率。此外,本文是建立哥伦比亚和拉丁美洲跨国EVAR设备注册的第一步。材料和方法:单中心回顾性观察队列研究。从2011年到2017年,34例腹主动脉瘤(AAA)患者接受了EVAR治疗。数据是从患者的电子病历中收集的。结果:支架移植Endologicx Ba (Endologix, Irvine, CA, United States)、exuder (W.L. Gore, Newark, DE, United States)、Zenith (Cook Medical, Bloomington, IN, United States)和Nellix血管内动脉瘤密封系统(EVAS) (Endologix, Santa Rosa, CA, United States)在EVAR手术后没有出现任何内漏或任何类型的并发症。Aorfix (Lombard, Didcot,英国)和Endurant (Medtronic, Minneapolis, MN,美国)支架移植物的II型内漏率(1例和2例患者)分别为2.9%和5.8%,自发闭合。没有支架移植发生I、III或IV型内陷,也不需要任何血管内或开放的再干预。结论:本研究表明,在拉丁美洲人群中,使用不同类型的支架移植治疗AAA合并EVAR是安全可行的,术后临床效果良好。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
OUTCOMES OF DIFFERENT TYPES OF STENT-GRAFT IN ENDOVASCULAR ABDOMINAL AORTIC ANEURYSM REPAIR: LONG-TERM EXPERIENCE OF A HIGH COMPLEXITY COLOMBIAN CENTER, THE FIRST LATIN AMERICAN EXAMPLE
Introduction: Endovascular abdominal aortic aneurysm repair (EVAR) devices are associated with a higher rate of complications at 5-year follow-up. At least 30% of patients with EVAR devices require some type of reintervention (whether endovascular or open) at 10-year follow-up. These complications include endoleak, abdominal aortic aneurysms rupture, graft migration, occlusion or infection. The objective of this paper was to determine the rates of failure for each type of EVAR stent-graft used in our local population. Also, this paper is the first step to create a Colombian and Latin American transnational EVAR device registry. Material and method: Single-center retrospective observational cohort study. Thirty-four patients with abdominal aortic aneurysms (AAA) treated with EVAR were included from 2011 through 2017. Data were collected from the patients’ electronic medical records.Results: The stent-graft Endologicx Ba (Endologix, Irvine, CA, United States), Excluder (W.L. Gore, Newark, DE, United States), Zenith (Cook Medical, Bloomington, IN, United States), and Nellix endovascular aneurysm sealing system (EVAS) (Endologix, Santa Rosa, CA, United States) were not associated with any endoleaks or any type of complications after the EVAR procedure. The Aorfix (Lombard, Didcot, United Kingdom), and Endurant (Medtronic, Minneapolis, MN, United States) stent-grafts had rates of type II endoleak (in 1 and 2 patients) of 2.9% and 5.8%, respectively that closed spontaneously. No stent-graft developed type I, III or IV endoleaks or any endovascular or open reinterventions were needed. Conclusions: This study shows that the different types of stent-graft used for to treat AAA with EVAR can be used in a safe and feasible way with good postoperative clinical outcomes in the Latin American population.
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