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大动脉门分支和胸内血管大动脉修复 (TEVAR) 用于B型大动脉剖析
Mohamad Bashir1, Matti Jubouri2, Abdelaziz O Surkhi3
1Vascular and Endovascular Surgery, Velindre University NHS Trust, Health Education and Improvement Wales (HEIW), Cardiff, UK.
Annals of vascular surgery
|October 22, 2023
概括
胸内血管大动脉修复 (TEVAR) 用于B型大动脉解剖 (TBAD) 通常需要大动脉门分支,这与显著的死亡率和重新干预率有关. 未来的分支移植可能会消除脱枝,改善结果.
科学领域:
- 心血管外科心血管外科
- 血管外科 血管外科
- 血管内干预 血管内干预
背景情况:
- 胸内血管大动脉修复 (TEVAR) 已经改变了B型大动脉剖析 (TBAD) 治疗.
- 靠近的TEVAR可能需要覆盖左下关节动脉的起源,需要大动脉门去分支以进行重要分支 perfusion.
- 这项研究检查了TEVAR治疗TBAD期间大动脉门脱枝的差异.
研究的目的:
- 描述和描述在TBAD的TEVAR期间大动脉门脱枝的差异.
- 在TBAD患者中分析与不同大动脉门脱枝策略相关的结果.
主要方法:
- 一个多中心国际数据库 (2005-2021) 的回顾性分析.
- 包括使用TEVAR治疗的TBAD患者.
- 收集有关人口统计,疾病和手术特征以及术后结果 (死亡率,重新干预) 的数据.
- 使用IBM SPSS 26与卡普兰-梅尔生存分析进行统计分析.
主要成果:
- 分析了58名患者,46.6%患有复杂的TBAD.
- 2区是最常见的近邻着陆区.
- 左关节下动脉旁路在26% (1次中风) 进行.
- 10%的人经历了更多的近邻分支,这是死亡的风险因素.
- 总体而言,再干预和死亡率分别为17.2%和29.3%.
结论:
- 大动脉门脱枝结合TBAD的TEVAR与显著的死亡率有关.
- 未来的分支移植装置可以消除脱枝的需要,可能降低中风和重新干预率.
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