복부 대동맥류의 혈관내 치료: 122명에 대한 단일 기관 연구 = Endovascular Aortic Aneurysm Repair for Abdominal Aortic Aneurysm: Single Center Experience in 122 Patients

국문 초록 (Abstract)

목적: 단일 기관에서 시술한 복부 대동맥류의 혈관내 치료(endovascular aneurysm repair; 이하 EVAR)의 결과를 분석하고자 하였다.
대상과 방법: 복부 대동맥류로 EVAR를 시행받은 122명의 결과를 후향적으로 분석하였다. 성별, 나이, 대동맥류의 형태, 부적절한 동맥류 목, 시술 전과 후의 대동맥류 크기변화, 기술적 성공, 임상적 성공, 그리고 시술 후 합병증과 이차시술 여부에 대해 분석하였다.
결과: 남자 111명, 여자 11명이었다. 복부 대동맥류는 방추형(n = 108), 주머니모양(n = 3), 파열된(n = 11) 형태였으며 64명에서 부적절한 동맥류 목에 해당되었다. 시술 전 대동맥류의 평균 크기는 52.4 mm였으며 시술 후 110명(90.2%)에서 크기가 감소하거나 변화가 없었고, 8명(6.6%)에서 크기가 증가하였다. 모든 환자(100%)에서 기술적 성공을, 105명(86.1%)에서 임상적인 성공을 보였다. 혈관누출은 51명(41.8%)에서 관찰되었다. 15명(12.3%)에서 부가적인 시술이 필요하였으며 제1, 2형 혈관누출에 의한 경우가 각각 4명 그리고 스텐트-그라프트의 혈전성 폐색으로 인한 경우가 7명이었다.
결론: 복부 대동맥류의 치료에 있어서 EVAR는 기술적, 임상적 성공률이 높으며 합병증이 적은 안전하고 유용한 치료법이다.

다국어 초록 (Multilingual Abstract)

Purpose: To analyze a single center experience of endovascular aneurysm repair (EVAR) for abdominal aortic aneurysms.
Materials and Methods: Results of 122 patients who underwent EVAR were analyzed, retrospectively. Sex, age, aneurysmal morphology, hostile neck anatomy, preprocedural and postprocedural sac-diameter, technical and clinical success, postprocedural complication and need of additional procedure were analyzed.
Results: A total of 111 male and 11 female patients were included. Morphology of the aneurysms was as follows: fusiform (n = 108), saccular (n = 3) and ruptured type (n = 11). Sixty-four patients had hostile neck anatomy. The preprocedural mean sac-diameter was 52.4 mm. Postprocedural sac-diameter was decreased or stable in 110 patients (90.2%) and increased in 8 patients (6.6%). Technical success rate was 100% and clinical success rate was 86.1%. Fifty-one patients showed endoleak (41.8%) and 15 patients (12.3%) underwent secondary intervention due to type I endoleak (n = 4), type II endoleak (n = 4) and stent-graft thrombosis (n = 7).
Conclusion: EVAR is a safe and effective therapy for abdominal aortic aneurysm, and it has high technical success and clinical success rate, and low complication rate.

참고문헌 (Reference)

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