监控双重超声波在 carotid endarterectomy 之后引发了干预措施
Abigail Clark1, Katherine K McMackin1, Kristen Knapp2
1Division of Vascular and Endovascular Surgery, Department of Surgery, Cooper University Hospital, Camden, NJ.
Journal of vascular surgery
|October 7, 2023
概括
建议在 carotid endarterectomy (CEA) 后进行双重超声 (DUS) 监测,但这项研究发现36个月后 ipsilateral 静止症的干预率较低. 常规的DUS是对逆侧疾病的保证,但需要进一步的研究来优化监测.
科学领域:
- 血管外科 血管外科
- 诊断成像 诊断成像 诊断成像
背景情况:
- 目前的指导方针建议对特定的患者群体进行心脏内关节切除术 (CEA) 后的双重超声 (DUS) 监测.
- DUS监测的最佳持续时间及其干预收益仍然未确定.
- 需要通过消除不必要的测试来减少医疗保健支出.
研究的目的:
- 评估经过CEA后DUS监测引起的干预率.
- 通过评估对ipsilateral回和逆侧疾病进展的干预率来确定持续DUS监测的价值.
主要方法:
- 在2009年至2022年期间接受CEA的767名患者的回顾性图表审查.
- 纳入标准:年龄大于18岁的患者至少有一次术后DUS.
- 主要终点:根据DUS发现返回手术室进行干预;次要终点:扫描数量/持续时间,外科手术期间中风发生率.
主要成果:
- 40名 (5.2%) 患者由于DUS发现需要44次干预.
- 平均监测持续时间为26.4个月;平均每个患者的扫描为2.8.
- 3.7%的患者接受了对抗侧面疾病进展的干预;0.4%患有外科手术期间的中风.
结论:
- 在CEA后的ipsilateral重新干预率很低,在36个月后的复缩后的收益率很低.
- 定期的DUS监测对于中度的对侧疾病患者来说是有价值的.
- 需要进一步的研究来确定最佳的监测策略和患者选择标准.
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