■本文的主要目的是分析有关内漏的结果,再干预,以及使用EndurantII(Medtronic)和ZenithFlex(Cook)内移植物接受腹主动脉动脉瘤(AAA)血管内修复(EVAR)的患者与动脉瘤并发症相关的死亡。
■这是一个前景,2019年1月至2022年12月期间接受EVAR的AAA患者的连续队列研究.对两组患者进行了评估:Endurant组(使用EndurantII提交给EVAR的患者)和Zenith组(使用ZenithFlex提交给EVAR的患者)。
■共评估了156例患者。天顶组(67名患者,42.9%)和耐力组(89例患者,57.1%)。围手术期死亡率为5.1%,八名患者(六名患者Zenith组,和两个病人Endurant组,p=0.054)。有28例患者(17.9%)接受了动脉瘤的紧急修复(扩张或破裂),各组之间没有差异。晚期内漏36例(23.1%),Zenith组的发病率较高(23例患者,34.3%)比Endurant组(13例,14.6%,p=0.002),其中大多数是II型内漏(21例患者,13.4%)。有12例I型内漏,Zenith组的患病率(13.4%)也高于Endurant组(3.4%,p=0.002)。此外,关于肢体移植物闭塞(LGO),有9名患者(5.8%),Zenith组的患病率(9%)高于Endurant组(3.4%,p=0.045)。在Zenith组中,Kaplan-Meier在720天时的总生存率为82.3%,在Endurant组中为89.1%,组间无统计学意义(p=0.09)。在Zenith组中,在720天时,Kaplan-Meier的再干预自由度为82.8%,在Endurant组中为93.2%(p=0.001)。
■在本研究中,天顶移植物内漏发生率较高,动脉瘤相关死亡率,LGO和再干预比患者提交EndurantII内移植物。线性回归分析表明,内漏的存在,内移植物类型(Zenith移植物)和肢体移植物闭塞与较高的再干预率有关。
结论:在本研究中,天顶移植物内漏发生率较高,动脉瘤相关死亡率,与接受EndurantII内移植物的患者相比,肢体移植物闭塞和再干预。本文提供的主要影响和创新是在EVAR期间评估和选择适合AAA患者的最佳移植物的机会。
UNASSIGNED: The main objective of this paper is to analyze the outcomes regarding endoleaks, reinterventions, and death related to aneurysm complications in patients submitted to endovascular repair (EVAR) for abdominal aortoiliac aneurysm (AAA) using Endurant II (Medtronic) and Zenith Flex (Cook) endografts.
UNASSIGNED: This was a prospective, consecutive cohort
study of patients with AAA who underwent EVAR between January 2019 and December 2022. Two groups of patients were evaluated: Group Endurant (patients submitted to EVAR with the use of Endurant II) and Group Zenith (patients submitted to EVAR with the use of Zenith Flex).
UNASSIGNED: A total of 156 patients were evaluated. Group Zenith (67 patients, 42.9%) and Group Endurant (89 patients, 57.1%). The perioperative mortality was 5.1%, eight patients (six patients Group Zenith, and two patients Group Endurant, p=0.054). There were 28 patients (17.9%) submitted to urgent repair of the aneurysm (expansion or rupture), with no differences among the groups. There were 36 cases (23.1%) of later endoleak, with a higher incidence in Zenith group (23 patients, 34.3%) than Endurant group (13 patients, 14.6%, p=0.002), most of them Type II endoleak (21 patients, 13.4%). There were 12 cases of Type I endoleak, also with a higher prevalence in Zenith group (13.4%) than Endurant group (3.4%, p=0.002). Moreover, regarding limb graft occlusion (LGO), there were nine patients (5.8%), with a higher prevalence in Zenith group (9%) than Endurant group (3.4%, p=0.045). The overall survival in a Kaplan-Meier at 720 days was 82.3% in the Zenith group and 89.1% in the Endurant group, with no statistical significance among the groups (p=0.09). The freedom from reintervention rates in a Kaplan-Meier at 720 days was 82.8% in the Zenith group and 93.2% in the Endurant group (p=0.001).
UNASSIGNED: In this present
study, Zenith endograft had higher rates of endoleaks, aneurysms related mortality, LGO and reinterventions than patients submitted to Endurant II endografts. The linear regression analysis showed that the presence of endoleaks, type of endograft device (Zenith graft) and limb graft occlusion were related to higher reintervention rates.
CONCLUSIONS: In this present
study, Zenith endograft had higher rates of endoleaks, aneurysms related mortality, limb graft occlusions and reinterventions than patients submitted to Endurant II endografts. The main impact and the innovation that this article provides is an opportunity to evaluate and choose the best endograft suitable for the patient with AAA during EVAR.