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在复杂的内血管动脉瘤修复后,CTA监测保守的内皮瘤治疗

Lukas Fuchs¹, Anna Sotir¹, Johannes Klopf¹

¹Division of Vascular Surgery, Department of General Surgery, Medical University of Vienna, Vienna, Austria.

Journal of vascular surgery

|December 24, 2025

概括

在复杂的内血管动脉瘤修复 (coEVAR) 后的III型和混合内泄漏 (ELs) 显示自发解决. 用计算机断层扫描血管造影 (CTA) 进行成像监测可能适用于具有稳定的动脉瘤囊动态的选择患者.

科学领域:

血管外科血管外科
干预性放射学干预性放射学
医疗成像医学成像

背景情况:

复杂的内血管动脉瘤修复 (coEVAR) 可能导致内脏泄漏 (EL).
监测ELs对于预防动脉瘤囊扩大和破裂至关重要.
自发EL解决率和预测因素需要进一步调查.

研究的目的:

为了评估coEVAR后内泄漏 (ELs) 的自发解决率.
为了确定与自发EL分辨率相关的因素.
评估计算机断层扫描血管学 (CTA) 监测在治疗EL和稳定动脉瘤囊患者中的作用.

主要方法:

对接受coEVAR的230名患者进行了回顾性分析.
纳入标准:在没有动脉瘤囊扩大的情况下,在预释CTA时存在I型,III型或混合ELs.
随访CTA监测,如果出现显著的动脉瘤囊扩大,则应重新干预.

主要成果:

在释放前的CTA显示了75%的患者的EL.
第一种类型的ELs没有显示自发解决.
第三类EL在24个月后在83%的患者中自发消失;混合II/IIIEL在12个月后在50%的患者中消失.
较小的EL体积 (<9.37毫升) 显示出更快的分辨率趋势.
大动脉最大直径,动脉瘤囊收缩和外周动脉疾病 (PAD) 史是EL缓解的独立预测因素.

结论:

在患有稳定的动脉瘤囊动态的患者中,观察到III型和II/III型混合EL的自发解脱.
在coEVAR后,CTA监测可能是这些选择患者的可行选择.
在研究队列中没有报告动脉瘤囊破裂.

关键词:

血管内脏手术血管内脏手术恩多利克管理的管理.再次干预,重新干预.

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