拉普科试验的长期结果
Brian F Buxton1,2, Philip A Hayward2, Jai Raman1,2
1Department of Cardiac Surgery, Austin Hospital, Melbourne, Australia (B.F.B., J.R., S.C.M., S.S., G.M.).
Circulation
|October 5, 2020
概括
在冠状动脉绕道手术中,放射性动脉 (RA) 与右侧内胸动脉 (RITA) 和静脉 (SV) 移植相比,具有较高的长期通透性. 这种改善的透视度也可能与更好的患者存活率相关.
科学领域:
- 心血管外科
- 血管移植
- 临床试验
背景情况:
- 冠状动脉旁路移植 (CABG) 通常使用内胸动脉移植.
- 对于CABG的第二个管道的最佳选择仍然是争论的主题.
- 为了解决这一争议,启动了放射性动脉病率和临床结果 (RAPCO) 试验.
研究的目的:
- 为了比较放射性动脉 (RA) 与右侧内胸动脉 (RITA) 的长期移植通透性.
- 为了比较放射性动脉 (RA) 与静脉 (SV) 的长期移植通透性.
主要方法:
- 在RAPCO- RITA中,有394名患者被随机分配到RA或自由RITA移植.
- 在RAPCO- SV中,有225名患者随机接受RA或SV移植.
- 主要结局:10年移植失败;次要结局:10年患者存活率.
主要成果:
- 10 年的RA通透率 (89%) 显著高于自由的RITA (80%) 和SV (71%).
- 与RITA (HR 0.45) 和SV (HR 0.40) 相比,RA显示移植失败的风险较低.
- 与RITA (90. 9% 与83. 7%) 和SV (72. 6% 与65. 2%) 相比,RA组的10年生存率更高.
结论:
- 放射性动脉的10年穿透率明显高于自由RITA和SV移植.
- 这些发现支持使用放射性动脉作为CABG中有利的第二导管.
- 改善RA的移植通透性可能会提高患者的长期存活率.
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