在内血管修复后 (rARE) 破裂腹腔大动脉动脉瘤的死亡率和危险因素
Melissa Jones1, Peter Faris2, Randy Moore1
1Division of Vascular Surgery, Department of Surgery, Peter Lougheed Centre, Calgary, Alberta, Canada.
概括
血管内修复后破裂 (rARE) 不常见,但有助于死亡率. 虽然30天死亡率与初级腹腔大动脉动脉瘤破裂 (rAAA) 类似,但识别从干预中受益的患者需要进一步研究.
科学领域:
- 血管外科 血管外科
- 血管内修复 血管内修复
- 大动脉动脉瘤管理管理
背景情况:
- 内血管动脉瘤修复 (EVAR) 是腹腔大动脉动脉瘤的常见治疗方法.
- 在EVAR (RARE) 之后的破裂是一种罕见但严重的并发症.
- 了解RARE的风险因素对于改善患者的治疗结果至关重要.
研究的目的:
- 在内血管修复后 (rARE) 进行下腹腔大动脉动脉瘤破裂的风险因素的特征.
- 为了比较RARE的30天死亡率与初级破裂腹腔大动脉动脉瘤 (rAAA).
主要方法:
- 在第三级护理中心对rAAA成年患者的回顾性审查 (2006-2018).
- 鉴定了267名患有rAAA的患者,其中11名患有rARE.
- 由于样本规模较小,使用了描述性统计数据.
主要成果:
- 在RARE (27.3%) 和初级rAAA (31.5%) 之间,总体30天死亡率相似.
- 患有RARE的患者更有可能接受息治疗 (18.2%对3.9%).
- 所有罕见病例都有内分泌漏洞;1型和3型内分泌漏洞是主要原因 (9/11),但2型也为此做出了贡献 (2/11).
- 四名罕见病患者没有囊扩张,四人失去了随访.
结论:
- 罕见是EVAR的不常见并发症,导致晚期死亡率.
- 需要进行更大规模的研究,以确定从干预中受益的罕见患者.
- 内皮和囊扩张可能表明风险增加,但缺席并不排除破裂. 对后续的损失是一个重要的风险因素.
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