腹主动脉瘤腔内修复术后Ⅱ型内漏的防治进展

Research progress on the prevention and treatment of typeⅡendoleak after endovascular abdominal aortic aneurysm repair

Ⅱ型内漏是腹主动脉瘤腔内修复术(EVAR)后的常见并发症,对EVAR手术患者的预后有较大的影响。预防Ⅱ型内漏的方法主要是在术中置入支架之前进行瘤囊分支动脉的栓塞,或置入支架后使用Onyx胶或其他特殊材料进行瘤囊的填充。治疗方法有保守治疗、栓塞治疗(经动脉途径、经腰途径、经腔静脉途径)、腹腔镜下动脉结扎手术、开放手术等,在临床上应用较多的是经动脉途径和经腰途径栓塞治疗。关于Ⅱ型内漏的预防、治疗方法,目前暂无统一标准。该文对近年来Ⅱ型内漏预防、治疗方面研究进展进行综述,以期为临床医生的临床决策提供参考。

TypeⅡendoleak is a frequently encountered complication following endovascular abdominal aortic aneurysm repair(EVAR),exerting significant impact on the prognosis of patients post-EVAR.The primary strategies for preventing typeⅡendoleak involve prestent implantation embolization of the branch artery within the aneurysm sac or post-stent implantation filling of the sac with Onyx or other specialized materials.Treatment modalities encompass conservative management,embolization(via transarterial,translumbar,transcaval approaches),laparoscopic artery ligation,open surgery,among others.Transarterial and translumbar embolizations are commonly employed in clinical practice.Currently,there exists no consensus regarding the prevention and treatment of typeⅡendoleak.This article provides a review of recent research advancements in this domain to offer reference and assistance to clinicians in their clinical decision-making.