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在冠状动脉外科手术中用于冠状动脉静脉移植的外部支架:系统性审查和元分析

Giovanni Jr Soletti¹, Arnaldo Dimagli¹, Lamia Harik¹

¹Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York, NY 10065, USA.

Journal of clinical medicine

|December 9, 2023

概括

使用静脉外部支T (VEST) 装置进行外部支,减少了沙静脉移植 (SVGs) 中的内密增生. 然而,这并没有降低冠状动脉旁路移植 (CABG) 后的移植阻塞或重复复血管化率.

科学领域:

心血管外科心血管外科
血管生物学血管生物学
生物医学工程生物医学工程

背景情况:

在动物研究的基础上,软静脉移植 (SVGs) 的外部支架显示在减少内密增生 (IH) 方面具有前途.
静脉外支持T (VEST) 装置是一种外部支架,旨在改善冠状动脉旁路移植 (CABG) 中的SVG结果.

研究的目的:

进行一项元分析,评估VEST设备对接受CABG的患者SVG结局的影响.
评估VEST支架在移植封闭,重复血管化和SVG结构变化的影响.

主要方法:

一个系统的搜索确定了随机对照试验 (RCT),比较VEST-stented和非stentedSVGs.
总共有407名患者的两个RCT被纳入了分析.
主要结局是移植塞;次要结局包括重复血管化,SVG IH区域和内腔-介质厚度.

主要成果:

在1.5年的随访中,在移植封闭 (IRR: 1.11;95% CI: 0.80-1.53) 或重复血管化 (OR: 0.66;95% CI: 0.27-1.64) 中没有显著差异.
在VEST组中,在SVG内密增生区域 (SMD: -0.45;95%CI: -0.79至 -0.10) 和内密-中介厚度 (SMD: -0.50;95%CI: -0.90至 -0.10) 中观察到显著的减少.
这些结构性改善并没有转化为在研究的时间点改善的临床结果.

结论:

在SVGs中,VEST外部支架显著降低了亲密增生症和亲密介质厚度.
这些有益的结构变化并没有导致移植阻塞的减少或在CABG后1.5年需要重复血管化.
需要进一步的研究来确定VEST支架在CABG患者的长期临床疗效.

关键词:

根据CABG的规定.这是一件西服.冠状动脉疾病是一种冠状动脉疾病.外部支架是一种外部支架.植入物阻塞植入物阻塞亲密性增生症是什么?重复重复的血管化.沙芬静脉移植是什么意思

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