双C臂透视系统在腹主动脉瘤腔内修复术中的临床价值

Clinical impacts of dual C-arm fluoroscopy in endovascular abdominal aortic aneurysm repair

摘要

目的 评估双C臂透视系统引导下腹主动脉瘤腔内修复术(endovascular aneurysm repair, EVAR)的临床效能,并与传统单C臂系统进行对比。方法 回顾性分析2021年2月至2023年12月期间接受EVAR治疗的51例腹主动脉瘤患者。根据术中使用的血管造影系统将患者分为单C臂组(n=28)和双C臂组(n=23)。比较两组支架移植物释放时间、总透视时间及辐射剂量(DAP)等关键术中参数。所有计量资料均进行正态性检验(Shapiro-Wilk检验)和方差齐性检验(Levene检验),根据检验结果选择适当的统计方法进行比较。结果 双C臂组的支架移植物释放时间显著短于单C臂组[中位数(四分位数):2.00(1.00,2.50)min vs. 3.23(2.00,5.75)min,P=0.021]。单C臂组与双C臂组的总透视时间[(12.27±6.17)min vs.(12.24±8.74)min,P=0.988)]、DAP[中位数(四分位数):11 245.50(7 265.25,18 875.75)μGy·m² vs. 12 560.00(8 450.00,18 520.00)μGy·m²,P=0.720]以及临床结局差异无统计学意义。结论 双C臂透视系统能显著缩短EVAR过程中的支架移植物释放时间,且不增加透视时间和辐射暴露剂量,可提供更佳手术视野,提高手术效率。

Abstract

Objective To evaluate the clinical impacts of dual C-arm fluoroscopy in guiding endovascular aneurysm repair (EVAR) compared with the conventional single C-arm system. Methods A retrospective study was conducted on 51 patients who underwent EVAR between February 2021 and December 2023. The patients were divided into two groups based on the fluoroscopy system used: the single C-arm group (n=28) and the dual C-arm group (n=23). Intraoperative parameters, including stent deployment time, fluoroscopy time and radiation dose (DAP), were compared between the two groups. Normality and homogeneity of variance for all continuous variables were tested using the Shapiro-Wilk test and Levene's test, respectively, to guide the choice of appropriate statistical tests. Results The dual C-arm group demonstrated significantly shorter stent deployment time [2.00 (1.00,2.50) minutes] compared to the single C-arm group [3.23(2.00,5.75) minutes, P=0.021]. There was no significant difference in total fluoroscopy time [(12.27±6.17) vs.(12.24±8.74) minutes, P=0.988] or DAP [median (quartile): 11 245.50(7 265.25,18 875.75) vs. 12 560.00(8 450.00,18 520.00) μGy·m², P=0.720]. The two groups had similar clinical outcomes. Conclusion The dual C-arm fluoroscopy system significantly reduces stent deployment time during EVAR without increasing fluoroscopy time or radiation exposure. This system can improve procedural efficiency, particularly in complex abdominal aortic aneurysm cases, and offers enhanced visualization.

关键词

腹主动脉瘤腔内修复术(EVAR) / 腹主动脉瘤(AAA) / 双C臂透视 / 手术效率

Key words

endovascular aneurysm repair (EVAR) / abdominal aortic aneurysm (AAA) / dual C-arm fluoroscopy / procedural efficiency

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基金资助

国家自然科学基金项目(81400276)

国家重点研发计划项目(2016YFC1301900)

国家重点研发计划项目(2016YFC1301901)