目的:真正的股浅动脉瘤(SFAA)很少见,传统上通过开放修复进行治疗。然而,采用覆膜支架排除动脉瘤囊的血管内途径可能是一种选择.本研究旨在比较开放和腔内修复SFAA的结果。
方法:这是一个回顾性研究,观察,单中心研究。主要终点是:技术成功,保肢和初级通畅率,住院时间。
结果:我们在40例患者中确定了49例SFAA;平均年龄为73.3±10.1岁,SFAA的平均直径为5.41±3.64cm,61.2%的患者有缺血或压迫相关症状。开放修复的适应症主要适用于涉及股浅动脉远端三分之一和同侧pop动脉瘤的复杂SFAA。在36名开放修复患者中,33例通过旁路或移植物介入进行结扎和血运重建,3例患者接受了简单的结扎而没有血运重建。血管内途径主要用于位于SFAA内侧三分之一的动脉瘤,其中12例患者行覆膜支架置入术,1例患者行线圈栓塞术。在所有情况下,技术成功率均为100%。在2年和4年时,两组之间的主要通畅性和保肢率没有统计学差异。开放和血管内治疗后平均住院时间为10±4和3±1天,分别。
结论:血管内途径可能是隔离SFAA的有效替代方法,具有良好的效果和较短的住院时间。开放式维修仍然是一种有效的方法,特别是在复杂的动脉瘤中。
OBJECTIVE: True superficial femoral artery aneurysms (SFAAs) are rare and traditionally treated by open repair. However, the endovascular approach excluding the aneurysm sac with a covered stent may be an alternative. This study aimed to compare the outcomes of the open and endovascular repair of SFAAs.
METHODS: This is a retrospective, observational, monocentric study. The main endpoints were: technical success, limb salvage and primary patency rate, and hospitalisation time.
RESULTS: We identified 49 SFAAs in 40 patients; the mean age was 73.3±10.1 years, the mean diameter of SFAAs was 5.41±3.64cm, and 61.2% were symptomatic for ischaemic or compression-related signs. The indication for open repair was given mainly for complex SFAAs involving the distal third of the superficial femoral artery and with an ipsilateral popliteal aneurysm. Among the 36 open-repair patients, 33 underwent ligation and revascularisation via bypass or graft interposition, and 3 patients underwent simple ligation without revascularisation. The endovascular approach was adopted mainly for aneurysms located in the medial third of the SFAA, which underwent covered stenting in 12 patients and coil embolisation in 1 patient. The technical success was 100% in all cases. There were no statistical differences in terms of primary patency and limb salvage rate between groups at two and four years. The mean hospitalisation time was 10±4 and 3±1 days after open and endovascular treatment, respectively.
CONCLUSIONS: The endovascular approach may be a valid alternative for isolating SFAAs offering good results and shorter hospitalisation. Open repair remains a valid approach, particularly in complex aneurysms.