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复杂的大动脉病理的先进内血管治疗
Ruojia Debbie Li1, Michael C Soult2
1Division of Vascular Surgery and Endovascular Therapy, Department of Surgery, Loyola University, Stritch School of Medicine, Maywood, IL, USA. Electronic address: https://twitter.com/RDebbieLi.
The Surgical clinics of North America
|October 15, 2023
概括
内血管大动脉动脉瘤修复比开放手术更有好处,但在30%-40%的病例中受到患者解剖学的限制. 短子或复杂动脉瘤等解剖学约束限制了内血管修复的适用性.
科学领域:
- 血管外科 血管外科
- 血管内干预 血管内干预
背景情况:
- 内血管大动脉动脉瘤修复 (EVAR) 和胸部内血管大动脉修复 (TEVAR) 与开放式手术修复相比具有优势.
- 益处包括减少血液损失,缩短手术时间,减少住院时间,降低死亡率和发病率.
研究的目的:
- 突出主动脉动脉瘤内血管修复的好处.
- 确定限制血管内动脉修复应用的解剖学限制.
主要方法:
- 对现有文献进行比较,对腹部和胸部大动脉动脉瘤进行内血管和开放外科修复的综述.
- 对抗内血管方法的解剖学因素的分析.
主要成果:
- 与开放式手术相比,内血管修复显著减少了外科手术期间的并发症和恢复时间.
- 解剖学上的局限性,如短的下子,过度的大动脉角和大动脉分支 (上大动脉干,内脏动脉,内动脉) 的参与,排除了30-40%的患者从EVAR/TEVAR.
结论:
- 在解剖学上可行时,Evar和Tevar是对大动脉动脉瘤的有效治疗方法.
- 患者的选择至关重要,因为特定的解剖特征需要替代治疗策略.
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