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紧急的内血管大动脉修复需要覆盖左下关节动脉的左下关节动脉
Peter L Haldenwang1, Christoph Heute2, Karla J Schero3
1Department of Cardiothoracic Surgery, Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil, Bochum, Nordrhein-Westfalen, Germany.
The Thoracic and cardiovascular surgeon
|July 7, 2023
概括
在胸内血管大动脉修复 (TEVAR) 期间管理左下关节动脉 (LSA) 是安全的. 在仔细评估血管解剖学时,覆盖LSA提供了与远端TEVAR可比的结果.
科学领域:
- 血管外科 血管外科
- 心血管成像 - 心血管成像
- 干预心脏病学 干预心脏病学
背景情况:
- 对于涉及大动脉的急性大动脉综合征,胸内血管大动脉修复 (TEVAR) 需要仔细考虑左下关节动脉 (LSA) 管理.
- 最佳的LSA管理策略旨在平衡治疗疗效与潜在的并发症,如中风或脊髓缺血.
研究的目的:
- 评估不同左下关节动脉 (LSA) 管理技术在胸内血管大动脉修复 (TEVAR) 期间的安全性和有效性,在急性大动脉综合征患者需要近距离降落在远部大动脉门.
- 基于完全LSA覆盖,部分LSA覆盖或没有LSA覆盖 (对照组) 的结果进行比较.
主要方法:
- 在2017年3月至2021年5月期间,对52名接受TEVAR治疗的患者进行了回顾性分析,以检测急性大动脉综合征与近端着陆在远端大动脉中.
- 患者被分为完全LSA覆盖 (35%),部分LSA覆盖 (17%) 或对照 (仅裸体泉水,48%) 组.
- 评估的结果包括30天和1年死亡率,中风,脊髓缺血 (SCI),阻 perfusion,以及需要重新干预.
主要成果:
- 技术成功率为96%. 两组之间没有观察到30天死亡率,中风或SCI的显著差异.
- 一年后的随访显示,在所有LSA管理组 (0-8%) 中,死亡率,中风和SCI的比例相似.
- 大动脉再干预率各不相同,完全覆盖率为6%,部分覆盖率为22%,对照组为13%.
结论:
- 在TEVAR期间覆盖左下关节动脉 (LSA) 是一个安全的策略,当进行彻底的血管解剖评估时.
- 涉及LSA覆盖的TEVAR结果可能与修复从LSA远处开始的结果相似.
- 在紧急的TEVAR病例中,个性化患者评估对于确定最佳的LSA管理方法至关重要.
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