全穿刺技術與股動脈切開腔內修復術治療無癥狀腹主動脈瘤的早期療效比較_《中國修復重建外科雜志》

作者：

熊江 , 衛任 , 郭偉 , 劉小平 , 賈鑫 , 馬曉輝 , 張宏鵬 , 張敏宏 , 張佳

解放軍總醫院血管外科全軍血管外科中心（北京，100853）;

關鍵詞：

全穿刺技術腔內修復術股動脈切開腔內修復術無癥狀腹主動脈瘤

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目的通過與股動脈切開腔內修復術（surgical femoral cutdown endovascular aneurysm repair，SFCEVAR）比較，探討全穿刺技術腔內修復術（total percutaneous endovascular aneurysm repair，TPEVAR）治療無癥狀腹主動脈瘤（asymptomatic abdominal aortic aneurysm，AAAA）的早期療效。方法2010年1月－2011年5月，收治AAAA患者41例，其中26例采用TPEVAR治療（TPEVAR組），15例采用SFCEVAR治療（SFCEVAR組）。TPEVAR組最大瘤體直徑為3.5～9.2 cm，平均5.7 cm；SFCEVAR組最大瘤體直徑為3.5～10.0 cm，平均6.9 cm。兩組性別及年齡比較，差異均無統計學意義（P gt; 0.05），具有可比性。結果兩組手術均成功。兩組患者術后均獲隨訪，隨訪時間6～23 個月，平均13.5個月。兩組主體輸送系統外徑、髂支輸送系統外徑、手術時間、造影劑使用量、住院時間和術后住院時間比較，差異均無統計學意義（P gt; 0.05）；SFCEVAR組術中出血量及ICU時間較TPEVAR組顯著增加（P lt; 0.05）；TPEVAR組2 例（7.7%）、SFCEVAR組5例（33.3%）出現輕微并發癥，兩組比較差異無統計學意義（χ2=4.42，P=0.08）。SFCEVAR組3 例（20.0%）出現嚴重并發癥，顯著高于TPEVAR組（0例）（χ2=5.61，P=0.02）。結論TPEVAR治療AAAA的早期安全性和有效性優于SFCEVAR。

引用本文： 熊江,衛任,郭偉,劉小平,賈鑫,馬曉輝,張宏鵬,張敏宏,張佳. 全穿刺技術與股動脈切開腔內修復術治療無癥狀腹主動脈瘤的早期療效比較. 中國修復重建外科雜志, 2012, 26(11): 1348-1351. doi: 復制

1.	Traul DK, Clair DG, Gray B, et al. Percutaneous endovascular repair of infrarenal abdominal aortic aneurysms: a feasibility study. J Vasc Surg, 2000, 32(4): 770-776.
2.	O?uzkurt L, Gürel K, Eker E, et al. Ultrasound-guided puncture of the femoral artery for total percutaneous aortic aneurysm repair. Diagn Interv Radiol, 2012, 18(1): 92-95.
3.	Al-Khatib WK, Zayed MA, Harris EJ, et al. Selective use of percutaneous endovascular aneurysm repair in women leads to fewer groin complications. Ann Vasc Surg, 2012, 26(4): 476-482.
4.	Sarmiento JM, Wisniewski PJ, Do NT, et al. The Kaiser permanente experience with ultrasound-guided percutaneous endovascular abdominal aortic aneurysm repair. Ann Vasc Surg, 2012, 26(7): 906-912.
5.	Ryer EJ, Garvin RP, Webb TP, et al. Comparison of outcomes with coils vs vascular plug embolization of the internal iliac artery for endovascular aortoiliac aneurysm repair. J Vasc Surg, 2012. [Epub ahead of print].
6.	Ni ZH, Luo JF, Huang WH, et al. Totally percutaneous thoracic endovascular aortic repair with the preclosing technique: a case-control study. Chin Med J (Engl), 2011, 124(6): 851-855.
7.	Torsello GB, Kasprzak B, Klenk E, et al. Endovascular suture versus cutdown for endovascular aneurysm repair: a prospective randomized pilot study. J Vasc Surg, 2003, 38(1): 78-82.
8.	Börner G, Ivancev K, Sonesson B, et al. Percutaneous AAA repair: is it safe? J Endovasc Ther, 2004, 11(6): 621-626.
9.	Watelet J, Gallot JC, Thomas P, et al. Percutaneous repair of aortic aneurysms: a prospective study of suture-mediated closure devices. Eur J Vasc Endovasc Surg, 2006, 32(3): 261-265.
10.	Lee WA, Brown MP, Nelson PR, et al. Midterm outcomes of femoral arteries after percutaneous endovascular aortic repair using the Preclose technique. J Vasc Surg, 2008, 47(5): 919-923.
11.	Eisenack M, Umscheid T, Tessarek J, et al. Percutaneous endovascular aortic aneurysm repair: a prospective evaluation of safety, efficiency, and risk factors. J Endovasc Ther, 2009, 16(6): 708-713.
12.	Jahnke T, Schäfer JP, Charalambous N, et al. Total percutaneous endovascular aneurysm repair with the dual 6-F Perclose-AT preclosing technique: a case-control study. J Vasc Interv Radiol, 2009, 20(10): 1292-1298.
13.	Etezadi V, Katzen BT, Naiem A, et al. Percutaneous suture-mediated closure versus surgical arteriotomy in endovascular aortic aneurysm repair. J Vasc Interv Radiol, 2011, 22(2): 142-147.
14.	Pol RA, Zeebregts CJ, van Sterkenburg SM, et al. Thirty-day outcome and quality of life after endovascular abdominal aortic aneurysm repair in octogenarians based on the Endurant Stent Graft Natural Selection Global Postmarket Registry (ENGAGE). J Vasc Surg, 2012, 56(1): 27-35.
15.	Lee WA, Brown MP, Nelson PR, et al. Total percutaneous access for endovascular aortic aneurysm repair (“Preclose” technique). J Vasc Surg, 2007, 45(6): 1095-1101.

1. Traul DK, Clair DG, Gray B, et al. Percutaneous endovascular repair of infrarenal abdominal aortic aneurysms: a feasibility study. J Vasc Surg, 2000, 32(4): 770-776.
2. O?uzkurt L, Gürel K, Eker E, et al. Ultrasound-guided puncture of the femoral artery for total percutaneous aortic aneurysm repair. Diagn Interv Radiol, 2012, 18(1): 92-95.
3. Al-Khatib WK, Zayed MA, Harris EJ, et al. Selective use of percutaneous endovascular aneurysm repair in women leads to fewer groin complications. Ann Vasc Surg, 2012, 26(4): 476-482.
4. Sarmiento JM, Wisniewski PJ, Do NT, et al. The Kaiser permanente experience with ultrasound-guided percutaneous endovascular abdominal aortic aneurysm repair. Ann Vasc Surg, 2012, 26(7): 906-912.
5. Ryer EJ, Garvin RP, Webb TP, et al. Comparison of outcomes with coils vs vascular plug embolization of the internal iliac artery for endovascular aortoiliac aneurysm repair. J Vasc Surg, 2012. [Epub ahead of print].
6. Ni ZH, Luo JF, Huang WH, et al. Totally percutaneous thoracic endovascular aortic repair with the preclosing technique: a case-control study. Chin Med J (Engl), 2011, 124(6): 851-855.
7. Torsello GB, Kasprzak B, Klenk E, et al. Endovascular suture versus cutdown for endovascular aneurysm repair: a prospective randomized pilot study. J Vasc Surg, 2003, 38(1): 78-82.
8. Börner G, Ivancev K, Sonesson B, et al. Percutaneous AAA repair: is it safe? J Endovasc Ther, 2004, 11(6): 621-626.
9. Watelet J, Gallot JC, Thomas P, et al. Percutaneous repair of aortic aneurysms: a prospective study of suture-mediated closure devices. Eur J Vasc Endovasc Surg, 2006, 32(3): 261-265.
10. Lee WA, Brown MP, Nelson PR, et al. Midterm outcomes of femoral arteries after percutaneous endovascular aortic repair using the Preclose technique. J Vasc Surg, 2008, 47(5): 919-923.
11. Eisenack M, Umscheid T, Tessarek J, et al. Percutaneous endovascular aortic aneurysm repair: a prospective evaluation of safety, efficiency, and risk factors. J Endovasc Ther, 2009, 16(6): 708-713.
12. Jahnke T, Schäfer JP, Charalambous N, et al. Total percutaneous endovascular aneurysm repair with the dual 6-F Perclose-AT preclosing technique: a case-control study. J Vasc Interv Radiol, 2009, 20(10): 1292-1298.
13. Etezadi V, Katzen BT, Naiem A, et al. Percutaneous suture-mediated closure versus surgical arteriotomy in endovascular aortic aneurysm repair. J Vasc Interv Radiol, 2011, 22(2): 142-147.
14. Pol RA, Zeebregts CJ, van Sterkenburg SM, et al. Thirty-day outcome and quality of life after endovascular abdominal aortic aneurysm repair in octogenarians based on the Endurant Stent Graft Natural Selection Global Postmarket Registry (ENGAGE). J Vasc Surg, 2012, 56(1): 27-35.
15. Lee WA, Brown MP, Nelson PR, et al. Total percutaneous access for endovascular aortic aneurysm repair (“Preclose” technique). J Vasc Surg, 2007, 45(6): 1095-1101.

《中國修復重建外科雜志》

全穿刺技術與股動脈切開腔內修復術治療無癥狀腹主動脈瘤的早期療效比較

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《中國修復重建外科雜志》

全穿刺技術與股動脈切開腔內修復術治療無癥狀腹主動脈瘤的早期療效比較

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

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Content

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