活性囊管理用于预防内血管动脉瘤修复后的II型内泄漏
Jeffrey R Nagel1,2, Wouter Driessen3, Erik Groot Jebbink1,3
1Multi-Modality Medical Imaging (M3I) Group, Technical Medical Centre, University of Twente, Enschede, The Netherlands.
VASA. Zeitschrift fur Gefasskrankheiten
|October 16, 2025
概括
预防性栓塞可显著减少II型内泄 (T2EL) 并促进内血管动脉瘤修复 (EVAR) 后动脉瘤囊回归. 这种策略在改善临床结果和减少并发症方面看起来很有希望.
科学领域:
- 血管外科 血管外科
- 干预性放射学 干预性放射学
- 医疗器械技术 医疗器械技术
背景情况:
- 二型内泄 (T2EL) 是内血管动脉瘤修复 (EVAR) 后最常见的并发症.
- 动脉瘤囊回归是成功EVAR结果的关键指标.
- T2EL与动脉瘤囊的稳定性和生长有关,强调需要采取预防措施.
研究的目的:
- 系统地审查和对预防性治疗策略的证据进行元分析,以防止EVAR后的内脏泄漏.
- 评估预防性栓塞对T2EL发生率,动脉瘤囊改造和重新干预率的影响.
- 为了确定预防性栓塞能否改善EVAR后的临床结果.
主要方法:
- 在Scopus,PubMed和Web of Science数据库中进行了系统的文献搜索.
- 包括原始研究报告预防性栓塞技术,以防止内脏泄漏.
- 对T2EL发生率,囊改造 (生长和收缩) 和T2EL相关的重新干预进行了元分析.
主要成果:
- 预防性栓塞可显著降低6,12和24个月的T2EL发病率 (ORs从0.20到0.29不等).
- 栓塞组显示显著减少囊生长和增加囊收缩在所有时间点.
- 栓塞组的再干预率较低,尽管在统计学上并不显著.
结论:
- 预防性栓塞,包括非选择性囊填充或选择性侧枝栓塞,导致EVAR后更好的临床结果.
- 这一策略显示了提高囊回归率和降低T2EL发病率的潜力.
- 需要进一步的研究来评估预防性栓塞对其他临床结果参数的长期影响.
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