胸腹主动脉夹层瘤和退行性胸腹主动脉瘤腔内治疗结果对比研究

doi:10.6040/j.issn.1671-7554.0.2024.0466

Abstract

Abstract: Objective To evaluate the feasibility and safety of endovascular aortic repair for post-dissection and degenerative thoracoabdominal aortic aneurysms by comparing their therapeutic effects. Methods We retrospectively collected the clinical data(including baseline data, surgical data, perioperative indicators, and follow-up indicators)from 34 patients with post-dissection thoracoabdominal aortic aneurysms and 25 patients with degenerative thoracoabdominal aortic aneurysms who underwent endovascular aortic repair in Shanghai General Hospital from December 2021 to February 2024. Results The success rate of endovascular aortic repair in both the post-dissection thoracoabdominal aortic aneurysm group and the degenerative thoracoabdominal aortic aneurysm group was 100%. The perioperative mortality rate in the post-dissection aneurysm group was 0, with cerebral infarction in 1 case(2.94%), type III leakage in 1 case(2.94%), and post-graft implantation syndrome in 3 cases(8.82%); while in the degenerative aneurysm group, 2 patients(8.00%)died and 1 case(4.00%)experienced acute kidney injury. During the follow-up period, 1 case(2.94%)died, 2 cases(5.88%)had aneurysm progressions, 1 case(2.94%)had type III internal leakage, 3 cases(8.82%)had branch vessel restenosis or occlusion, and 5 cases(14.71%)were re-intervened in the post-dissection aneurysm group; while in the degenerative aneurysm group, 0 cases died, 1 case(4.00%)had aneurysm progression, 1 case(4.00%)had type Ⅰ endoleak, 1 case(4.00%)had type III endoleak, 2 cases(8.00%)had branch vessel restenosis or occlusion, and 3 cases(12.00%)experienced re-intervention. There was no significant difference in perioperative and follow-up outcomes between the two groups(P>0.05). Conclusion Endovascular aortic repair for post-dissection and degenerative thoracoabdominal aortic aneurysms has similar technical success rates and early and mid-term outcomes. However, the results of this study need to be verified with more cases and longer follow-up time to further investigate the safety and efficacy of endovascular aortic repair for thoracoabdominal aortic aneurysms, especially the mid-term and long-term efficacy.

Key words: Post-dissection thoracoabdominal aortic aneurysms, Degenerative thoracoabdominal aortic aneurysms, Endovascular aortic repair, Mid-term results, Re-intervention

CLC Number:

R654.3

QU Jin, ZENG Zhaoxiang, HE Mengwei, HUO Weixue, ZHANG Heng, LU Ye, TIAN Wen, FENG Rui. Comparative outcomes of endovascular aortic repair for post-dissection and degenerative thoracoabdominal aortic aneurysms[J].Journal of Shandong University (Health Sciences), 2024, 62(11): 14-21.

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Comparative outcomes of endovascular aortic repair for post-dissection and degenerative thoracoabdominal aortic aneurysms

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