使用放射性动脉进行冠状动脉旁路移植:临床结果,通透性和需要重新干预的需要
Robert F Tranbaugh1, Kamellia R Dimitrova, Patricia Friedmann
1Division of Cardiac Surgery, Beth Israel Medical Center, First Ave at 16 St, New York, NY 10003, USA. rtranbau@chpnet.org
Circulation
|September 12, 2012
概括
放射性动脉移植为冠状动脉旁路移植提供了优秀的长期结果,显示出高穿透率,与左侧内胸动脉相美. 这种有效的再血管化策略显示,重新干预的需求最小,支持更广泛的使用.
科学领域:
- 心血管外科心血管外科
- 血管移植 血管移植
- 冠状动脉疾病 冠状动脉疾病
背景情况:
- 放射性动脉移植是冠状动脉绕道移植 (CABG) 中左侧内胸动脉之后的一个有希望的替代性动脉导管.
- 放射性动脉移植的长期疗效和重新干预率仍未完全确定.
研究的目的:
- 评估在接受冠状动脉旁路移植的患者中放射性动脉移植的长期结果和移植通透性.
- 为了比较辐射动脉移植的性能与软静脉和内胸动脉移植.
主要方法:
- 在1851名患者的回顾性队列研究中,这些患者在16年内接受了初级,孤立的CABG.
- 分析包括移植通透性,患者存活率和再干预率 (心脏导管,PCI,重复CABG).
- 植入物通透度定义为>50%的狭窄,弦符号或闭塞.
主要成果:
- 一年,五年,10年和15年的生存率分别为99%,96%,89%和75%.
- 放射性动脉移植的通透率为82%,而沙静脉移植的通透率为47% (P<0.0001).
- 放射性动脉移植通透率 (85%) 与左侧内胸动脉移植通透率 (85%,P=0.3) 相似.
结论:
- 放射性动脉移植是一种高效的重血管化策略,具有优异的短期和长期结果.
- 放射性动脉移植的通透性优于软静脉移植,与左侧内胸动脉移植相当.
- 建议在CABG中更广泛地利用放射性动脉移植,因为其重新干预率低,通透率有利.
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