友好的部解剖学并不能防止EVAR后与部相关的不良事件
Paavo Paajanen1, Jari Karjalainen2, Marianne Jaroma2
1Heart Center, Kuopio University Hospital, Kuopio, Finland; University of Eastern Finland, Kuopio, Finland.
Annals of vascular surgery
|July 16, 2023
概括
内血管动脉瘤修复 (EVAR) 后续需要风险分层. 敌对的部解剖学没有预测长期不良事件,但大动脉瘤直径增加了风险,需要密切监测.
科学领域:
- 血管外科 血管外科
- 医疗成像医学成像
- 患者的治疗结果.
背景情况:
- 在内血管动脉瘤修复 (EVAR) 后终身随访是昂贵和繁的.
- 需要基于EVAR故障风险进行分层的随访.
- 动脉瘤部解剖学是EVAR成功的一个关键因素.
研究的目的:
- 为了研究动脉瘤部解剖学,作为EVAR后部相关不良事件的预测因素.
- 评估部解剖学对EVAR结果的长期影响.
- 为了确定EVAR后不良事件的风险因素.
主要方法:
- 对222名接受EVAR治疗的患者进行了一项回顾性单一中心研究,用于腹腹动脉动脉瘤 (2011-2016).
- 截至2020年12月,每年进行成像后续检查.
- 敌对的部,以长度,宽度,角度,化,血栓或圆形状来定义;部相关的不良事件包括破裂,重新干预或1a型内泄.
主要成果:
- 41%的患者有敌对的部解剖学;30天死亡率或重大不良事件没有显著差异.
- 敌对部患者的生存率在1年和5年较低;动脉瘤相关的死亡率在6年后更高.
- 动脉瘤直径≥70mm是一个独立的风险因素,与近4倍的部相关并发症风险增加有关.
结论:
- 在EVAR后,友好的部解剖学可能不能保证对长期部相关不良事件的保护.
- 患有大动脉瘤 (≥70毫米) 的患者需要特别密切的长期随访.
- 在部解剖学之外的风险分层,考虑到动脉瘤的大小,对于EVAR管理至关重要.
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