Original Articles Korean Circulation J 1999;299:907-912 Bifurcated Stent-GraftVanguard 를이용한 복부대동맥류의경관적치료 심원흠 1 최동훈 1 윤영섭 1 이도연 2 장병철 3 Bifurcated Stent-GraftVanguard for the Endovascular Treatment of Abdominal Aortic Aneurysm Won-Heum Shim, MD 1, Donghoon Choi, MD 1, Young Sup Yoon, MD 1, Do-Yun Lee, MD 2 and Byung-Chul Jang, MD 3 1 Cardiology Division, 2 Radiology, 3 Cardiovascular Surgery, Yonsei Cardiovascular Center, Yonsei University, Seoul, Korea ABSTRACT PurposeThe purpose of this study was to evaluate the safety, feasibility and effectiveness of an endoluminallyplaced bifurcated stent-graft (Vanguard) for the treatment of infrarenal abdominal aortic aneurysm (AAA). MethodsTransluminal endovascular stent-graft placements were attempted in 29 patients (28 male, mean age 697 years) with AAAs involving the common iliac arteries from Aug. 1997 to Jan. 1999. Endovascular therapy was performed in the cardiac catheterization laboratory with epidural anesthesia. One side of the femoral artery was opened by surgical cutdown for the bifurcated stent-graft entry and the other side was punctured percutaneously for the straight stent-graft. Computed tomography and/or intraarterial angiography were performed during an average follow-up of 10 months (218 months). ResultsPrimary success rate was 75.9% (22 of 29 patients) and the overall success rate was 79.3% with successful correction of one perigraft leak. Twenty patients (69.0%) had significant coronary artery disease. There were two technical failure cases, the one was tortuous iliac vessel with spasm, the other was disconnection of the stent-graft connecting portion. Complications related to procedure occurred in 13.8% of patients (4 of 29 patients) and two of these four patients had procedure-related mortality because of acute renal failure following contrast overdose and sepsis after operation. ConclusionsEndovascular treatment of infrarenal AAA with bifurcated stent-graft (Vanguard ) is effective, feasible and relatively safe. However, further investigation for the outcome, complication and long-term follow-up are needed. Korean Circulation J 1999;292:907-912 KEY WORDSAbdominal aortic aneurysm Bifurcated Stent-graft Endovascular treatment. 서 론 907
연구대상및방법 908 A B Fig. 1. Stent-Grafts used for the endoluminal treatment of infrarenal abdominal aortic aneurysms. AThe main body is implanted with use of a delivery system inserted through a surgical cutdown. BThe contralateral iliac limb is inserted percutaneously. Korean Circulation J 1999;299:907-912
A B Fig. 2. Implantation of a bifurcated stent-graft in a 72-year-old patient with an infrarenal abdominal aortic aneurysm with involvement of the both internal iliac arteries. AInitial angiography and computed tomography obtained before the procedure show an infrarenal abdominal aortic aneurysm with involvement of the both internal iliac arteries. And follow-up computed tomography confirms the exclusion of the aortic aneurysmal sac. BSchematic treatment method for the infrarenal abdominal aortic aneurysm with involvement of the both internal iliac arteries. 연구결과 909
고안 910 Korean Circulation J 1999;299:907-912
연구배경 : 요약 대상및방법 : 결과 : 911
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