Endovascular AAA Repair: Prevention of Side Branch Endoleaks with Thrombogenic Sponge

摘要: PURPOSE To report a technique that might decrease the incidence of lumbar artery endoleaks following endovascular repair (EVR) abdominal aortic aneurysms (AAAs). METHODS Ninety-three patients (86 males, median age 72 years, range 56 to 88) undergoing EVR with aortomonoiliac were entered into study detect and then occlude patent side branches before completion endografting procedure. Prior deploying iliac occluder, an aneurysmogram was performed branches. If these found, absorbable gelatin sponge inserted aneurysm sac via occluder introducer sheath. The followed contrast-enhanced spiral computed tomography (CT) at 1 week 3, 6, 12 months presence endoleaks. RESULTS Forty-eight (52%) demonstrated occluded by insertion sponges sac. remaining 45 without evidence branch flow untreated. Ten (10.7%) died in perioperative period, 15 (16.1%) primary (13 proximal, 2 distal) detected. This left 68 (73.1%) for follow-up, 33 (48.5%) whom had vessels treated thrombogenic sponge. follow-up 4 (range 17), during which time no endoleak detected on surveillance CT scans any patients, included all those been identified. CONCLUSIONS We have safe reliable method preventing AAA repair.