Influence of Proximal Aneurysm Neck Anatomy on TypeⅠA Endoleak Following Endova-scular Repair for Infrarenal Abdominal Aortic Aneurysm_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 JINGChong ,  WANGHao-fu , LIUJun-jun , LIJun , WANGYue-wei , ZHAOZong-gang , LIYong-xin , ZHUJin-tong

Department of Vascular Surgery, Affiliated Hospital of Qingdao University, Qingdao 266003, Shandong Province, China;

Corresponding?author：

WANGHao-fu, Email: wanghf2003@126.com

Keywords：

Abdominal aortic aneurysm; Endovascular repair; Endoleak; Stent

DOI：

10.7507/1007-9424.20150244

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To determine the influence of proximal aneurysm neck anatomy on typeⅠA endoleak follo-wing endovascular aortic aneurysm repair (EVAR) for infrarenal abdominal aortic aneurysm. Methods From September 2007 to February 2014, 111 consecutive patients with non-ruptured abdominal aortic aneurysms were treated with EVAR. The preoperative CTA of abdominal aortic was obtained by every patient, and the three-dimensional imaging was reconstructed and measured by software of Osorix. Then, the relation between the recurrence of typeⅠA endoleak and the concerned data measured by Osorix was analyzed by the statistical software. Results The recurrence of typeⅠA endo-leak was related to the proximal neck angle of the abdominal aortic aneurysm, which weren't related to the proximal neck diameter and variation rates, the mural thrombas and calcification rate, and the maximum diameter of abdominal aortic aneurysm by multivariate analysis. Conclusions The complicated proximal aneurysm neck anatomy is a major cause for the typeⅠA endoleak, the proximal neck angle of the abdominal aortic aneurysm is the independent factor. The applica-tion of EVAR depends largely on the shape of the proximal aneurysm neck.

Citation： JINGChong, WANGHao-fu, LIUJun-jun, LIJun, WANGYue-wei, ZHAOZong-gang, LIYong-xin, ZHUJin-tong. Influence of Proximal Aneurysm Neck Anatomy on TypeⅠA Endoleak Following Endova-scular Repair for Infrarenal Abdominal Aortic Aneurysm. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2015, 22(8): 937-941. doi: 10.7507/1007-9424.20150244 Copy

1.	Parodi JC, Palmaz JC, Barone HD. Transfemoral intraluminal graft implantation for abdominal aortic aneurysms. Ann Vasc Surg, 1991, 5(6):491-499.
2.	EVAR trial participants. Endovascular aneurysm repair versus open repair in patients with abdominal aortic aneurysm (EVAR trial 1):randomised controlled trial. Lancet, 2005, 365(9478):2179-2186.
3.	樊昆, 任為.覆膜支架腔內隔絕和開腹手術治療腹主動脈瘤破裂療效比較.中國修復重建外科雜志, 2012, 26(7):827-831.
4.	O'brien G, Martin Z, Haider N, et al. An analysis of vascular surgery in elderly patients to determine whether age affects treatment strategy. Ir J Med Sci, 2012, 181(1):73-76.
5.	Grisafi JL, Rahbar R, Nelms J, et al. Challenging neck anatomy is associated with need for intraoperative endovascular adjuncts during endovascular aortic aneurysm repair (EVAR). Ann Vasc Surg, 2011, 25(6):729-734.
6.	Chambers D, Epstein D, Walker S, et al. Endovascular stents for abdominal aortic aneurysms:a systematic review and economic model. Health Technol Assess, 2009, 13(48):1-189, 215-318, iii.
7.	Georgiadis GS, Trellopoulos G, Antoniou GA, et al. Early results of the endurant endograft system in patients with friendly and hostile infrarenal abdominal aortic aneurysm anatomy. J Vasc Surg, 2011, 54(3):616-627.
8.	黃小勇, 郭曦, 韓曉峰, 等.近腎動脈腹主動脈開窗機分支支架腔內修復術.心肺血管病雜志, 2013, 32(6):724-728.
9.	Antoniou GA, Georgiadis GS, Antoniou SA, et al. A meta-analysis of outcomes of endovascular abdominal aortic aneurysm repair in patients with hostile and friendly neck anatomy. J Vasc Surg, 2013, 57(2):527-538.
10.	張宏鵬, 郭偉, 劉小平, 等.腹主動脈瘤腔內修復術中不良近端錨定區對內漏的影響.中華普通外科雜志, 2012, 27(7):523-526.
11.	Norgren L, Hiatt WR, Dormandy JA, et al; TASCⅡWorking Group. Inter-Society Consensus for the management of peripheral arterial disease (TASCⅡ). J Vasc Surg, 2007, 45(Suppl S):S5-S67.
12.	Chaikof EL, Blankensteijn JD, Harris PL, et al. Reporting standards for endovascular aortic aneurysm repair. J Vasc Surg, 2002, 35(5):1048-1060.
13.	王豪夫, 王曰偉, 李君, 等.腹主動脈瘤腔內修復術22例圍手術期處理回顧性總結.介入放射學雜志, 2010, 19(11):858-861.
14.	Schermerhorn ML, O, malley AJ, Jhaveri AA, et al. Endovascular vs. open repair of abdominal aortic aneurysms in the Medicare population. N Engl J Med, 2008, 358(5):464-474.
15.	Greenhalgh RM, Brown LC, Powell JT, et al; United Kingdom EVAR Trial Investigators. Endovascular versus open repair of abdominal aortic aneurysm. N Engl J Med, 2010, 362(20):1863-1871.
16.	郭發才, 代遠斌.腹主動脈瘤腔內修復術后內漏診治的研究進展.中國普外基礎與臨床雜志, 2011, 18(4):455-461.
17.	Sampaio SM, Panneton JM, Mozes GI, et al. Proximal typeⅠendo-leak after endovascular abdominal aortic aneurysm repair:predic-tive factors. Ann Ann Vasc Surg, 2004, 18(6):621-628.
18.	Dillavou ED, Muluk SC, Rhee RY, et al. Does hostile neck anatomy preclude successful endovascular aortic aneurysm repair? J Vasc Surg, 2003, 38(4):657-663.
19.	郭偉, 張國華, 蓋魯粵, 等.帶膜支架腔內搭橋治療動脈瘤附6例報告.中華醫學雜志, 1999, 79(12):903-905.
20.	Goetti R, Winklehner A, Gordic S, et al. Automated attenuation-based kilovoltage selection:preliminary observations in patients after endovascular aneurysm repair of the abdominal aorta. AJR Am J Roentgenol, 2012, 199(3):W380-W385.
21.	張強, 羅英偉, 王新文, 等.腹主動脈瘤形態學特點及臨床意義.中華外科雜志, 2001, 39(8):583-585.

1. Parodi JC, Palmaz JC, Barone HD. Transfemoral intraluminal graft implantation for abdominal aortic aneurysms. Ann Vasc Surg, 1991, 5(6):491-499.
2. EVAR trial participants. Endovascular aneurysm repair versus open repair in patients with abdominal aortic aneurysm (EVAR trial 1):randomised controlled trial. Lancet, 2005, 365(9478):2179-2186.
3. 樊昆, 任為.覆膜支架腔內隔絕和開腹手術治療腹主動脈瘤破裂療效比較.中國修復重建外科雜志, 2012, 26(7):827-831.
4. O'brien G, Martin Z, Haider N, et al. An analysis of vascular surgery in elderly patients to determine whether age affects treatment strategy. Ir J Med Sci, 2012, 181(1):73-76.
5. Grisafi JL, Rahbar R, Nelms J, et al. Challenging neck anatomy is associated with need for intraoperative endovascular adjuncts during endovascular aortic aneurysm repair (EVAR). Ann Vasc Surg, 2011, 25(6):729-734.
6. Chambers D, Epstein D, Walker S, et al. Endovascular stents for abdominal aortic aneurysms:a systematic review and economic model. Health Technol Assess, 2009, 13(48):1-189, 215-318, iii.
7. Georgiadis GS, Trellopoulos G, Antoniou GA, et al. Early results of the endurant endograft system in patients with friendly and hostile infrarenal abdominal aortic aneurysm anatomy. J Vasc Surg, 2011, 54(3):616-627.
8. 黃小勇, 郭曦, 韓曉峰, 等.近腎動脈腹主動脈開窗機分支支架腔內修復術.心肺血管病雜志, 2013, 32(6):724-728.
9. Antoniou GA, Georgiadis GS, Antoniou SA, et al. A meta-analysis of outcomes of endovascular abdominal aortic aneurysm repair in patients with hostile and friendly neck anatomy. J Vasc Surg, 2013, 57(2):527-538.
10. 張宏鵬, 郭偉, 劉小平, 等.腹主動脈瘤腔內修復術中不良近端錨定區對內漏的影響.中華普通外科雜志, 2012, 27(7):523-526.
11. Norgren L, Hiatt WR, Dormandy JA, et al; TASCⅡWorking Group. Inter-Society Consensus for the management of peripheral arterial disease (TASCⅡ). J Vasc Surg, 2007, 45(Suppl S):S5-S67.
12. Chaikof EL, Blankensteijn JD, Harris PL, et al. Reporting standards for endovascular aortic aneurysm repair. J Vasc Surg, 2002, 35(5):1048-1060.
13. 王豪夫, 王曰偉, 李君, 等.腹主動脈瘤腔內修復術22例圍手術期處理回顧性總結.介入放射學雜志, 2010, 19(11):858-861.
14. Schermerhorn ML, O, malley AJ, Jhaveri AA, et al. Endovascular vs. open repair of abdominal aortic aneurysms in the Medicare population. N Engl J Med, 2008, 358(5):464-474.
15. Greenhalgh RM, Brown LC, Powell JT, et al; United Kingdom EVAR Trial Investigators. Endovascular versus open repair of abdominal aortic aneurysm. N Engl J Med, 2010, 362(20):1863-1871.
16. 郭發才, 代遠斌.腹主動脈瘤腔內修復術后內漏診治的研究進展.中國普外基礎與臨床雜志, 2011, 18(4):455-461.
17. Sampaio SM, Panneton JM, Mozes GI, et al. Proximal typeⅠendo-leak after endovascular abdominal aortic aneurysm repair:predic-tive factors. Ann Ann Vasc Surg, 2004, 18(6):621-628.
18. Dillavou ED, Muluk SC, Rhee RY, et al. Does hostile neck anatomy preclude successful endovascular aortic aneurysm repair? J Vasc Surg, 2003, 38(4):657-663.
19. 郭偉, 張國華, 蓋魯粵, 等.帶膜支架腔內搭橋治療動脈瘤附6例報告.中華醫學雜志, 1999, 79(12):903-905.
20. Goetti R, Winklehner A, Gordic S, et al. Automated attenuation-based kilovoltage selection:preliminary observations in patients after endovascular aneurysm repair of the abdominal aorta. AJR Am J Roentgenol, 2012, 199(3):W380-W385.
21. 張強, 羅英偉, 王新文, 等.腹主動脈瘤形態學特點及臨床意義.中華外科雜志, 2001, 39(8):583-585.

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Influence of Proximal Aneurysm Neck Anatomy on TypeⅠA Endoleak Following Endova-scular Repair for Infrarenal Abdominal Aortic Aneurysm

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