在使用VQI数据集的F/BEVAR中,上肢接入的结果更差
Rohini J Patel1, Agustin Sibona2, Mahmoud B Malas1
1Division of Vascular and Endovascular Surgery, Department of Surgery, University of California San Diego, San Diego, CA.
Annals of vascular surgery
|August 13, 2023
概括
使用上肢 (UEM) 接入的医生修饰内脏移植 (F/BEVAR) 与全移植 (TTF) 接入相比,死亡,心肌梗塞和中风的风险更高. 此外,TTF还提供更短的操作时间和更少的访问站点并发症.
科学领域:
- 血管外科 血管外科
- 血管内修复 血管内修复
- 动脉瘤治疗 动脉瘤治疗
背景情况:
- 医生修改的内脏移植和定制设备可用于复杂动脉瘤的分支和窗体内血管动脉瘤修复 (F/BEVAR).
- 传统上,F/BEVAR通常需要上肢和下肢的访问.
- 新兴的技术允许通过转肢方法模拟上肢访问,这引发了安全问题.
研究的目的:
- 为了比较F/BEVAR手术的全膜 (TTF) 接入和混合上肢 (UEM) 接入之间的结果.
- 用国家数据库评估F/BEVAR中UEM访问相关的风险.
主要方法:
- 对F/BEVAR患者的血管质量倡议数据库 (2014-2021) 的分析.
- 将患者分为TTF与任何UEM接入组进行分层,用于目标血管支架部署.
- 主要结局:中风,心肌梗塞 (MI),术后死亡. 二次结果:接入点并发症,手术时间,光镜时间,技术成功.
主要成果:
- 3,146名F/BEVAR患者:2,309名 (73.4%) 的TTF和837名 (26.6%) 的UEM.
- 获得UEM与死亡/心脏病发作风险增加两倍,中风风险增加三倍有关.
- TTF组的手术和光镜时间显著缩短,接入部位血液瘤,闭塞和栓塞率较低.
结论:
- 与TTF访问相比,F/BEVAR利用UEM访问与外科手术期间心脏病发作,死亡和中风的风险显著增加.
- 整体关接入表明F/BEVAR手术的安全性和效率有所提高.
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