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结合性组织疾病患者内血管大动脉干预后的结果
Karl Wilhelm Olsson1, Kevin Mani1, Anne Burdess1
1Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.
JAMA surgery
|June 14, 2023
概括
结合性组织疾病 (CTD) 中的内血管大动脉修复显示出高成功率和可接受的中期存活率,挑战了以前的建议. 进一步的研究可能会支持将其纳入指南.
科学领域:
- 心血管外科心血管外科
- 遗传学 遗传学 是一个
- 血管医学 血管医学
背景情况:
- 血管内大动脉修复 (EVAR) 通常不建议用于连接组织疾病 (CTD),除非在特定情况下.
- 血管内技术的进步可能需要重新评估这一建议.
研究的目的:
- 评估诊断出CTD的患者中EVAR的中期结果.
- 评估这一群体的生存率,二次手术率和在EVAR后转换为开放修复的情况.
主要方法:
- 一项描述性回顾性研究,涉及来自18个大动脉中心的171名CTD患者 (Marfan,Loeys-Dietz,vEDS).
- 收集关于人口统计,干预和短期/中期结果 (2005-2020) 的数据,分析了2021年12月至2022年11月的数据.
主要成果:
- 高初级技术成功 (98.2%) 和低30天死亡率 (2.9%).
- 中期存活率与开放性修复相当,根据CTD类型而异 (例如,马凡综合征5年后80.6%).
- 二次手术的高率 (53.2%),但转换为开放维修的低率 (8.2%).
结论:
- 在CTD患者中,EVAR表现出高的早期技术成功率和低的术后死亡率.
- 中期存活率与开放性手术相当,这表明EVAR是一种可行的选择.
- 由于技术进步和有利的结果,EVAR可能会被纳入未来的CTD治疗指南.
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