无症状透性大动脉的预后:一种现代方法
Charles DeCarlo1, Christopher A Latz1, Laura T Boitano2
1Division of Vascular and Endovascular Surgery, Massachusetts General Hospital, Harvard Medical School, Boston (C.D., C.A.L., Y.K., S.I.S., J.M., A.D.).
Circulation
|August 11, 2021
概括
无症状的穿透性大动脉 (PAU) 呈现极小的生长和罕见的并发症. 建议对这些大动脉疾病进行保守的治疗,并进行成像和风险因素控制.
科学领域:
- 心血管医学
- 血管外科手术
- 放射学
背景情况:
- 关于无症状穿透性大动脉的自然史的数据有限.
- 对PAU的长期后续研究很少.
- 这项研究解决了了解PAU进展和不良事件的需要.
研究的目的:
- 为了确定无症状PAU随着时间的推移的增长速度.
- 评估无症状PAU患者的不良事件发生率.
- 确定PAU增长和并发症的预测因素.
主要方法:
- 追溯分析了2005年至2020年间诊断的273名无症状PAU患者的队列.
- 使用线性混合效应模型模拟了大小的变化.
- 使用累积发病率函数来估计不良事件发生率,并根据相应的风险进行调整.
主要成果:
- 无症状的PAU呈现最小的增长 (宽度:0. 23毫米/ 年,直径:0. 24毫米/ 年).
- 不良事件很少发生,破裂,进展或干预的累积发病率为3. 6%.
- 高血压,高脂血症,糖尿病,初始宽度> 20毫米,血栓化PAU和囊性动脉瘤与略大的尺寸变化有关.
结论:
- 无症状的穿透性大动脉的生长速度缓慢,并发症率低.
- 包括连续成像和风险因子修改在内的保守治疗是无症状PAU的可行策略.
- 进一步的研究可能会完善PAU的管理准则.
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