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在复杂的大动脉动脉瘤的窗体/分支内移植中,与上层中枢动脉相关的结果
E Gallitto1,2, G Faggioli1,2, A Vacirca1,2
1Vascular Surgery, University of Bologna-DIMEC, Bologna, Italy.
Frontiers in cardiovascular medicine
|September 29, 2023
概括
上层介质动脉 (SMA) 支架移植的耐用性对于窗体/分支内血管大动脉修复 (FB-EVAR) 是至关重要的. 简单的SMA定向影响了重新养的需求,大动脉直径预测了不良事件,但FB-EVAR显示了有希望的中期简单的SMA结果.
科学领域:
- 血管外科 血管外科
- 血管内主动脉修复 血管内主动脉修复
- 大动脉动脉瘤管理管理
背景情况:
- 在复杂的胸腔腹腔大动脉动脉瘤和胸腔腹腔大动脉动脉瘤中,上层中枢动脉 (SMA) 支架-移植的耐用性对于窗口/分支内血管大动脉修复 (FB-EVAR) 的成功至关重要.
- 了解FB-EVAR期间SMA整合的早期和中期结果对于优化患者管理和程序成功至关重要.
研究的目的:
- 评估在窗口/分支内血管大动脉修复 (FB-EVAR) 程序中加入的上层中枢动脉 (SMA) 支架移植的早期和中期结果.
- 确定影响SMA支架移植耐用性和相关不良事件的因素.
主要方法:
- 在2016年至2021年期间,对200个涉及SMA的FB-EVAR程序进行了回顾性审查.
- 根据SMA与大动脉之间的角度将SMA配置分为三种类型 (A,B,C).
- 评估与SMA相关的技术成功 (SMA-TS) 和不良事件 (SMA-AEs),包括狭窄,内,肠道缺血和死亡率.
主要成果:
- 与SMA相关的技术成功在所有情况下都实现了 (100%).
- 总体而言,7.5%的患者经历了SMA-AEs,狭窄和内泄是最常见的并发症.
- 在SMA水平上,大动脉直径≥35mm是SMA-AEs的独立预测因子 (OR: 4; 95% CI: 1.4-13.8; P=.01).
结论:
- SMA的方向影响了对支架-移植重新铺的需求,A型或C型配置与增加重新铺的必要性有关.
- 虽然大动脉直径≥35毫米是SMA-AEs的风险因素,但FB-EVAR显示了令人满意的SMA相关结果,具有出色的技术成功和有希望的中期临床结果.
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