髂动脉分支支架治疗髂动脉瘤的近期结果分析

Short-term results of iliac artery branch device in the treatment of iliac artery aneurysm

目的探讨利用髂动脉分支支架(IBD)保留髂内动脉并腔内隔绝髂动脉瘤的近期疗效。方法回顾性分析采用IBD治疗的髂动脉瘤患者的术前、术中、围手术期及随访资料。结果本次研究共收录8例患者,其中髂动脉瘤合并腹主动脉瘤6例(单侧4例,双侧2例),孤立性髂总动脉瘤2例。植入自制IBD支架1例,临床实验支架7例。技术成功率75%(6/8)。围手术期无死亡病例,无Ⅰ型、Ⅲ型内漏。8例患者均获得随访,随访时间1~8个月,臀肌跛行患者2例(为植入失败者),无其他不适。8例患者术后30d CTA检查,未见明显内漏,髂内分支支架血流通畅。3例术后6个月CTA检查,无内漏、髂内分支支架血流通畅。结论 IBD是髂动脉瘤腔内治疗中保留髂内动脉的有效方法,术前适应症选择及术中规范操作是提高技术成功率的关键。

Objective To investigate the short-term curative effect of using iliac branched device（IBD） for retaining the internal iliac artery and iliac aneurysm endovascular exclusion. Methods The data of preoperative, intraoperative, perioperative and follow-up of patients with iliac artery aneurysm treated with IBD were retrospectively analyzed. Results The study included a total of 8 patients, including iliac aneurysm with abdominal aortic aneurysm in 6 cases（unilateral in 4 cases, bilateral in 2 cases）, isolated common iliac artery aneurysm in 2 cases. One case of self-made IBD stent and seven cases of clinical trial stent were implanted. Technical success rate 75%（6/8）. No perioperative deaths, no type I, type III endoleak. All 8 patients were followed up for 1 to 8 months. Two patients with gluteal muscle claudication（with failed implant） had no other discomfort. 8 cases of CTA 30 days after the operation, no significant endoleak, internal iliac stent flow unobstructed. 3 cases of CTA 6 months after surgery, no leakage, internal iliac stent blood flow unobstructed. Conclusion IBD is an effective method of preserving the internal iliac artery in the treatment of iliac artery aneurysm, preoperative indications choice and operation of the standard operation is to improve the technical success rate of the key.