Comparative Analysis Of Endovascular Repair And Its Results For Abdominal Aortic Aneurysms With Different Diameters

Objective:Synthetically analyzing the clinical data of patients with abdominal aortic aneurysms of different diameters.To probe into the differences in abdominal aortic aneurysms for endovascular repair and its results.In order to provide a reference for the clinical choice of the appropriate sizes standard of abdominal aortic aneurysms at the time of endovascular repair.Methods:We had collected a total of 92 patients with abdominal aortic aneurysm endovascular repair of the Second Affiliated Hospital of Nanchang University Vascular Surgery from January 2009 to June 2015.Male 75 cases,female 17 cases;age from 51 to 86 years old,average age(72.3+6.1)years old;the diameters of abdominal aortic aneurysms from minimum 34 mm to maximum 103 mm.By preoperative computed tomography angiography(computed tomography angiography,CTA)being diagnosed,and measuring the maximum diameters of abdominal aortic aneurysms.According to the abdominal aortic aneurysms maximum diameter compiling for the groups,abdominal aortic aneurysms maximum diameter is less than or equal to 50 mm series for group?,maximum diameter is greater than 50 mm and less than or equal to60 mm series for group ?,maximum diameter is greater than 60 mm series for Group?.Comparative analysized abdominal aortic aneurysms morphology,perioperative,postoperative complications and patients med-term and long-term survival,by using analysis of variance,respectively,chi-square test,Cox proportional hazards models and Kaplan-Meier survival analysis of three groups of patients with clinical data.Results:There were 92 cases in three groups,25 cases in group?(27.2%),36 cases in group ?(39.1%)and 31 cases in group ?(33.7%).The mean age of group?was(67.5±5.6)years old and group ?(70.8±6.2)years old and group ?(73.7±5.4)years old.The differences during the three groups was significant(p<0.05),and the smallerAAA patients were younger.The group?combined with heart diseases(group?20%,group?33.3%,group ?51.6%,p<0.05)were less than the other two groups.Most of patients of group?was accompanied by abdominal pain and other symptoms(symptomatic patients in group?40%,group? 13.9%,and group ?12.9%,p<0.05).There were significant differences in abdominal aortic aneurysms morphology among the three groups(p<0.05),in group I,the proximal neck was longer and the proximal neck was smaller in diameter and angle than the other,and group?was less nvolvement of iliac artery.Compared with group ?and group ?,the patients of group?were less implement internal iliac artery embolization and reconstruction and the number of grafts was less.There was significant difference in complications among the three groups during the perioperative period(p<0.05),and the incidence of complications in group I was lower than that in the other two groups.During the 3 to60 months of follow-up,leakage and all cause mortality were significantly lower than those in the other two groups(p<0.05).By multivariate analysis,it was found that the aneurysm size was an important factor affecting the leakage(p=0.029,RR=2.155)and survival rate(p=0.001,RR=1.437).Conclusion:The diameter of AAAs is a significant predictive factor of leakage and survival.Compared with large abdominal aortic aneurysms,the patients with small abdominal aortic aneurysms were younger and had less risk factors and had more suitable for endovascular repair.The maximum diameter of the abdominal aortic aneurysms had certain effects on the endovascular repair of abdominal aortic aneurysms and its results.The smaller abdominal aortic aneurysms were better than the large ones in the operation,perioperative complications and the follow-up period,and mid-term and long-term results.Recommended surgical intervention should be recommended as soon as possible.