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Open Versus Endovascular Repair of Isolated Iliac Artery Aneurysms

机译：Open与孤立的髂动脉动脉瘤的腹血管修复

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Purpose: Outcomes of open iliac artery repair (OIR) and endovascular iliac artery repair (EVIR) were compared at a tertiary referral vascular center. Methods: From 2004 to 2015, all patients treated for isolated iliac artery aneurysms (IAAs) were retrospectively identified, and patient records and computed tomography (CT) scans were analyzed. The primary end point was overall survival; secondary end points were 30-day mortality and morbidity and freedom from reintervention. For follow-up, data from outpatient visits and CT scans following a standard surveillance protocol were used. Results: A total of 106 IAAs in 94 patients were treated (mean follow-up: 35.7 months; 66 OIR; 40 EVIR). Six (15%) aneurysms from the EVIR group and 4 (6.1%) from open-operated IAA presented in the state of rupture. There was no difference in overall survival between EVIR and OIR (P = .14). In multivariable analysis, higher risk of death was associated with ruptured IAA (rIAA; hazard ratio [HR]: 40.44, 95% confidence interval [CI]: 2.05-796.18; P = .02) and coronary heart disease (HR: 11.07, 95% CI: 1.94-63.36; P .01). The 30-day mortality was 1.9% overall (0% OIR, 5.0% EVIR, P = .27), but there were no differences between OIR and EVIR in 30-day morbidity (P = .11). Freedom from reintervention was higher for OIR than for EVIR (P .01). In multivariable analysis, a higher reintervention rate was seen in EVIR (HR: 10.80, 95% CI: 2.20-53.01; P .01) and in rIAA (HR: 12.02, 95% CI: 1.31-111.11; P = .03). Conclusion: Iliac artery aneurysmss can be safely and effectively treated by EVIR or OIR regarding 30-day morbidity, mortality, and long-term survival, although freedom from reintervention is significantly lower after EVIR.
机译：目的：在第三节推荐血管中心进行比较开放髂动脉修复（OIR）和血管内髂骨动脉修复（EVIR）。方法：从2004年到2015年，回顾性识别出用于分离的髂动脉动脉瘤（IAAS）的所有患者，分析了患者记录和计算断层扫描（CT）扫描。主要终点是总体生存;次要终点为30天的死亡率和发病率和自由度。对于随访，使用了门诊访问和CT扫描的数据。结果：94例患者共有106例IAAS（平均随访：35.7个月; 66盎司; 40埃文人）。来自EVIR集团的六（15％）动脉瘤和4（6.1％）来自破裂状态的开放式IAA。 EVIR和OIR之间的整体生存没有差异（P = .14）。在多变量分析中，较高的死亡风险与IAA破裂（RIAA;危害比[HR]：40.44,95％置信区间[CI]：2.05-796.18; p = .02）和冠心病（HR：11.07， 95％CI：1.94-63.36; p＆ 01）。 30天的死亡率总体上为1.9％（0％OIR，5.0％EVIR，P = .27），但在30天的发病率（P = .11）中，OIR和EVIR之间没有差异（P = .11）。对OIR的自由度高于EVIR（P＆ .01）较高。在多变量分析中，在EVIR中观察到更高的重新入住率（HR：10.80,95％CI：2.20-53.01; P＆ 01）和RIAA（HR：12.02,95％CI：1.31-111.11; P =。 03）。结论：EVIR或OIR可以安全有效地治疗ILIAC动脉动脉瘤关于30天的发病率，死亡率和长期存活，尽管埃维尔后重新入侵的自由显着降低。

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