目的:腔内修复术是治疗主髂动脉瘤的首选方法,建议保留至少一条髂内动脉。本研究旨在评估来自全球Iliac分支研究(GIBS,NCT05607277)提高髂支装置(IBD)的选择标准并改善长期结果。
方法:对297例GIBS患者行动脉瘤腔内修复术的治疗前CT扫描结果进行分析。测量包括髂动脉总长,髂总动脉长度,弯曲指数,髂总动脉张开角,髂内动脉狭窄,钙化评分,和设备着陆区的直径。统计测试评估了解剖测量和IBD介导的髂内动脉保存的差异。
结果:左侧髂总动脉长度短于右侧(6.7mm,P=.0019);右髂总动脉不那么曲折(P=.0145)。男性左髂总动脉弯曲较大(P=.0475),左髂内动脉着陆区直径较大(P=.0453)。保留在权利上更为常见(158单方面,34双边)比左(105单边,34双边)。有192个右侧和139个左侧IBD,男性318例IBD,女性13例。
结论:本研究提供了接受IBDs血管内修复的患者的治疗前全面的髂关节解剖分析,强调双方和性别之间的差异。这些发现可以改善IBD患者的选择,可能增强主动脉髂动脉瘤治疗的结果。然而,研究中女性人数有限,这突显了需要进一步研究以推广跨性别的发现。
OBJECTIVE: Endovascular repair is the preferred treatment for aortoiliac aneurysm, with preservation of at least one internal iliac artery recommended. This
study aimed to assess pre-endovascular repair anatomical characteristics of aortoiliac aneurysm in patients from the Global Iliac Branch
Study (GIBS, NCT05607277) to enhance selection criteria for iliac branch devices (IBD) and improve long-term outcomes.
METHODS: Pre-treatment CT scans of 297 GIBS patients undergoing endovascular aneurysm repair were analyzed. Measurements included total iliac artery length, common iliac artery length, tortuosity index, common iliac artery splay angle, internal iliac artery stenosis, calcification score, and diameters in the device\'s landing zone. Statistical tests assessed differences in anatomical measurements and IBD-mediated internal iliac artery preservation.
RESULTS: Left total iliac artery length was shorter than right (6.7 mm, P = .0019); right common iliac artery less tortuous (P = .0145). Males exhibited greater tortuosity in the left total iliac artery (P = .0475) and larger diameter in left internal iliac artery\'s landing zone (P = .0453). Preservation was more common on right (158 unilateral, 34 bilateral) than left (105 unilateral, 34 bilateral). There were 192 right-sided and 139 left-sided IBDs, with 318 IBDs in males and 13 in females.
CONCLUSIONS: This
study provides comprehensive pre-treatment iliac anatomy analysis in patients undergoing endovascular repair with IBDs, highlighting differences between sides and sexes. These findings could refine patient selection for IBD placement, potentially enhancing outcomes in aortoiliac aneurysm treatment. However, the limited number of females in the
study underscores the need for further research to generalize findings across genders.