医学交流课件：SuccessfulTreatmentofProximalTypeIEndoleakafterEVAR.pptVIP

Multicentre In our center (SECS) Safe Effective Cheap Simple In your center (Is it SECS) Join us! Fibrin glue injection! 尊敬的各位领导，各位专家，我是来自长海医院野战医疗所重伤救治组的张雷，今天我汇报的题目是：从陆地到深蓝——海上医疗小分队的构建 Staged procedure was performed in 86 patients with persistent type I endoleak after first-line procedures (balloon dilation and stent/cuff placement), 48 additional procedure (16 stents, 32 cuffs) were placed in the initial attempts to resolve the type I endoleak. After fibrin glue injection, 84 (97.67%) of the 86 endoleaks were totally resolved immediately. The mean volume of fibrin glue was 17.7±8.8ml (from 10ml to 40ml). More than one third (33, 38.4%) patients received 10 ml of fibrin glue; only one-tenth (9, 10.5%) patient needed more than 30ml glue. One 80-year-old patient with persistent type I endoleak despite proximal cuff implantation and the use of 40 ml of glue, and then was converted to open surgery, the patient died from multi-organ dysfunction syndrome in the intensive care unit 2 weeks later. The other one with rupture AAA got a sudden death on the operation table after only 10 ml glue injection with very low blood pressure for nearly one hour. One patient who were successfully treated by fibrin glue injection succumbed to myocardial infarction within 7 days of the EVAR procedure and two patients with rupture AAA died from multi-organ dysfunction syndrome (mainly renal dysfunction because the high creatinine level before EVAR) 8 and 11 days after EVAR plus fibrin glue treatment (30-day mortality 5.8%). Successful treatment of fibrin glue embolization was confirmed with angiography of disappeared or diminished type I endoleak and the measurement of aneurysm sac pressure. Systolic, diastolic, mean, and pulse pressures and the MPI were all significantly decreased after fibrin glue injection, especially the pulse pressure (Table 2). The amplitude of the systolic-diastolic waveforms of the 84 successfully treated patients were re