简单的内血管动脉瘤修复的长期结果基于最初的大动脉直径
Yuki Orimoto1, Hiroyuki Ishibashi1, Takahiro Arima1
1Department of Vascular Surgery, Aichi Medical University, Nagakute, Aichi, Japan.
概括
最初的腹腔大动脉瘤直径会影响内血管动脉瘤修复 (EVAR) 后的结果. 在S组中较小的动脉瘤显示出更好的结果,而L组中较大的动脉瘤具有更高的并发症率,特别是在II型内漏病中.
科学领域:
- 血管外科 血管外科
- 血管内干预 血管内干预
- 大动脉动脉瘤管理管理
背景情况:
- 内血管动脉瘤修复 (EVAR) 是对腹腔大动脉瘤 (AAA) 的常见治疗方法.
- 患者选择和解剖学因素对于长期的EVAR成功至关重要.
- 初始AAA直径对EVAR后结果的影响需要进一步澄清.
研究的目的:
- 评估初始腹腔大动脉瘤 (AAA) 直径对囊行为,内脏泄漏和选择性EVAR后的再干预率的影响.
- 根据初始AAA大小,根据EVAR发现与不良事件相关的风险因素.
- 为了比较初始AAA直径较小和较大的患者之间的结果.
主要方法:
- 对228名患者的分析,在EVAR后进行了超过1年的随访.
- 根据性别特异性值 (男性<55毫米,女性<50毫米为S;男性≥55毫米,女性≥50毫米为L) 将初始AAA直径分为小 (S组) 和大 (L组) 的分类.
- 综合事件 (动脉瘤囊扩张≥10毫米和/或重新干预) 和相关因素的评估.
主要成果:
- 与L组 (79.1%) 相比,S组 (92.4%) 的五年无复合事件率明显高于L组 (79.1%).
- 在S组的初始AAA直径和排放时的II型内孔 (T2EL) 是复合事件的显著预测因素.
- 在L组中,当T2EL在排放时存在时,五年无复合事件率降至51%.
结论:
- 初始AAA直径较小的患者 (S组) 在EVAR后经历了更好的结果.
- 较大的初始AAA直径 (L组) 与更高的不良事件风险有关,特别是当II型内泄症复杂时.
- 第二种类型的内分泄漏显著恶化了接受EVAR的初始AAA较大的患者的结果.
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