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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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, 任为.覆膜支架腔内隔绝和开腹手术治疗腹主动脉瘤破裂疗效比较.中国修复重建外科杂志, 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.	黄小勇, 郭曦, 韩晓峰, 等.近肾动脉腹主动脉开窗机分支支架腔内修复术.心肺血管病杂志, 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.	张宏鹏, 郭伟, 刘小平, 等.腹主动脉瘤腔内修复术中不良近端锚定区对内漏的影响.中华普通外科杂志, 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, 王曰伟, 李君, 等.腹主动脉瘤腔内修复术22例围手术期处理回顾性总结.介入放射学杂志, 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.	郭发才, 代远斌.腹主动脉瘤腔内修复术后内漏诊治的研究进展.中国普外基础与临床杂志, 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.	郭伟, 张国华, 盖鲁粤, 等.带膜支架腔内搭桥治疗动脉瘤附6例报告.中华医学杂志, 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.	张强, 罗英伟, 王新文, 等.腹主动脉瘤形态学特点及临床意义.中华外科杂志, 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, 任为.覆膜支架腔内隔绝和开腹手术治疗腹主动脉瘤破裂疗效比较.中国修复重建外科杂志, 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. 黄小勇, 郭曦, 韩晓峰, 等.近肾动脉腹主动脉开窗机分支支架腔内修复术.心肺血管病杂志, 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. 张宏鹏, 郭伟, 刘小平, 等.腹主动脉瘤腔内修复术中不良近端锚定区对内漏的影响.中华普通外科杂志, 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, 王曰伟, 李君, 等.腹主动脉瘤腔内修复术22例围手术期处理回顾性总结.介入放射学杂志, 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. 郭发才, 代远斌.腹主动脉瘤腔内修复术后内漏诊治的研究进展.中国普外基础与临床杂志, 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. 郭伟, 张国华, 盖鲁粤, 等.带膜支架腔内搭桥治疗动脉瘤附6例报告.中华医学杂志, 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. 张强, 罗英伟, 王新文, 等.腹主动脉瘤形态学特点及临床意义.中华外科杂志, 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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