腹主动脉瘤腔内修复术后内漏危险因素及预后分析

Risk factors and outcomes of endoleak after endovascular aneurysm repair

目的探讨腹主动脉瘤腔内修复术后发生内漏相关危险因素及预后。方法回顾性分析2012年6月至2021年11月广西医科大学第一附属医院血管外科接受腔内手术治疗的肾下型腹主动脉瘤患者的临床资料。结果术后首次复查CT血管造影时299例患者中136例存在内漏。共有186例患者出院后至少复查了1次CT血管造影。过大的瘤颈成角是Ⅰa型内漏的危险因素(t=-6.108,P<0.001),更宽的髂总动脉直径(左侧Z=-2.787,P=0.005,右侧Z=-2.381,P=0.017)、髂动脉瘤(χ^(2)=6.398,P=0.011)是Ⅰb型内漏的危险因素,各型内漏组患者生存时间与无内漏组相比差异无统计学意义。结论过大的瘤颈成角是Ⅰa型内漏的独立危险因素,大部分内漏患者生存状况与无内漏者相当。

Objective To analyze the risk factors and prognosis of endoleak after endovascular aneurysm repair(EVAR)of abdominal aortic aneurysm.Methods The clinical data of patients with infrarenal abdominal aortic aneurysms treated by endovascular repair at the Department of Vascular Surgery,the First Affiliated Hospital of Guangxi Medical University from Jun 2012 to Nov 2021 were retrospectively analyzed.Results During the first follow-up CTA after surgery,136 out of 299 patients had endoleak.A total of 186 patients had at least one CTA reexamination after discharge.Statistical analysis showed that excessive neck angulation was an independent risk factor for typeⅠa endoleak(t=-6.108,P<0.001),wider common iliac artery diameter(left Z=-2.787,P=0.005,Right Z=-2.381,P=0.017)and iliac aneurysm(χ^(2)=6.398,P=0.011)were risk factors for typeⅠb endoleak.The survival time of patients in endoleak group was similar to no endoleak group.Conclusions Excessive neck angulation is an independent risk factor for typeⅠa endoleak.Most leaks resolve spontaneously,the prognosis is fair.