对于初级感染腹动脉动脉瘤的手术技术和结果的比较
Dana B Semaan1, Salim G Habib1, Michael Madigan1
1Division of Vascular Surgery, UPMC, Pittsburgh, PA.
Annals of vascular surgery
|January 1, 2024
概括
与内血管修复 (EVAR) 或外解剖修复 (EAR) 相比,开放式现场修复 (OIR) 证明感染腹腔大动脉动脉瘤的5年生存率有所改善. 在紧急情况下,Evar可以作为临时措施.
科学领域:
- 血管外科 血管外科
- 传染病管理 传染病管理
- 大动脉动脉瘤治疗方法
背景情况:
- 主要感染腹腔大动脉瘤 (PIAAAs) 存在显著的发病率和死亡率风险.
- 手术的选择包括开放的 in-situ 修复 (OIR),外解剖修复 (EAR) 和内血管腹腔大动脉瘤修复 (EVAR).
研究的目的:
- 为了比较PIAAA的OIR,EAR和EVAR的长期结果.
- 为了确定PIAAA患者死亡率的决定因素.
主要方法:
- 对43名PIAAA患者 (2000-2021) 的回顾性队列研究.
- 排除之前进行过大动脉手术的患者.
- 使用卡普兰-梅尔曲线和考克斯比例危险模型比较1年和5年死亡率.
主要成果:
- 三组修复组之间1年死亡率没有显著差异.
- 与EAR (53%) 和EVAR (72%) 相比,OIR显示出明显更好的5年生存率 (8%的死亡率).
- 与OIR相比,EVAR和EAR与5年死亡风险增加有关.
结论:
- 无论采用哪种方法,PIAA修复与高死亡率有关.
- OIR为PIAAA.提供了改善的长期生存.
- 在急性PIAAA病例中,EVAR可能是一个有用的临时策略.
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