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首页> 外文期刊>Vascular and endovascular surgery >Intraoperative Gutter Leaks That Merit Our Attention
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Intraoperative Gutter Leaks That Merit Our Attention

机译：术中的排水沟泄漏，这值得我们注意

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Introduction: The natural history and potential morbidity of gutter endoleaks are unclear. We present our experience with intraoperative gutter endoleaks and strategies to determine which of these require intervention. Methods: This is a retrospective review of all patients treated with parallel stent grafts from January 2010 to September 2015. We reviewed all operative records and intraoperative angiograms as well as all postoperative imaging and secondary interventions. All gutter leaks were classified as low-flow/nonsac-enhancing gutter endoleaks or high-flow/sac-enhancing gutter endoleaks. Adjunctive interventions to manage the gutter leaks were noted, as were all subsequent interventions for gutter leak and endoleak management. Results: Seventy-eight patients had 144 parallel stents placed over a 5-year period with an average of 1.8 stents per patient. Twenty-eight patients (36%) had gutter endoleaks diagnosed intraoperatively. Seventeen patients had adjunctive procedures to reduce gutter leaks prior to leaving the operating room (OR). Patients selected for treatment had gutters filling early during completion angiography and/or contrast enhancement of the aneurysm sac. Twenty-two patients (28%) left the OR with low-flow/delayed/nonsac-enhancing gutter endoleaks. At 30 days, a total of 6 persistent gutter endoleaks were diagnosed on computed tomographic angiography. This gives a 73% rate of resolution for low-flow/nonaneurysm sac-enhancing endoleaks. There were 2 de novo endoleaks not detected at the index procedure diagnosed at 6-month follow-up. Of the 8 total postoperative endoleaks, 5 required additional intervention with a 100% success rate. Multivariate analysis revealed that the only significant predictor of having a postoperative endoleak is leaving the OR with an endoleak. Conclusions: Intraoperative treatment of gutter endoleaks has an acceptable rate of resolution. It does have a high rate of converting high-flow endoleaks to low-flow endoleaks. Low-flow/nonsac-enhancing gutter endoleaks have a high rate of spontaneous resolution. Intraoperative gutter endoleaks are not predictive of future aneurysm sac growth. ]]>
机译：介绍：天沟螺旋寝的自然历史和潜在发病率尚不清楚。我们展示了我们对术中的沟槽内胚胎和策略的经验，以确定这些需要哪些干预。方法：这是从2010年1月到2015年9月的平行支架移植物治疗的所有患者的回顾性审查。我们审查了所有手术记录和术中血管造影以及所有术后成像和次要干预措施。所有排水沟泄漏都被归类为低流量/非洲增强的沟槽螺旋珠或高流量/囊囊增强的沟槽螺旋珠。注意到管理排水沟泄漏的辅助干预措施，正如排水沟泄漏和螺旋淋坏管理的所有后续干预都一样。结果：七十八名患者有144个平行支架，5年内，平均每位患者平均1.8天。二十八名患者（36％）有术中诊断的沟槽肌疙瘩。十七名患者有辅助程序，以在离开手术室（或）之前减少排水沟泄漏。选择治疗的患者在完成血管造影和/或动脉瘤囊的造影期间早期填充。二十二名患者（28％）留下了低流量/延迟/非洲加油排水沟螺旋淋坏。在30天内，诊断了总共6个持续的沟槽肌疙瘩在计算的断层血管造影上。这为低流量/腹腔囊囊囊增强的螺旋凸时提供了73％的分辨率率。在诊断为6个月随访的指数程序下没有检测到2 de Novo endoleaks。在8个术后止回阀中，5个需要额外的介入，以100％的成功率。多变量分析表明，术后胚乳的唯一显着预测因子是离开或用螺注或用螺栓。结论：沟槽腹腔内的术中治疗具有可接受的分辨率速率。它确实具有将高流量的螺栓转化为低流量的螺旋刀头。低流量/非洲增强沟槽螺旋展示具有高的自发分辨率。术中排水沟螺旋凸起未预测未来的动脉瘤囊生长。 ]]>

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