在患有和没有异常左脊椎解剖的患者中,对左脊椎动脉再血管化的比较研究
Eimaan S Shergill1, Farhad R Udwadia2, Maja Grubisic3
1Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
Journal of vascular surgery
|January 23, 2024
概括
对于异常解剖学而言,直接的脊椎再血管化增加了血栓形成和声等并发症的风险,但与间接的关节下动脉再血管化相比,它不会影响长期的死亡率.
科学领域:
- 血管外科 血管外科
- 心血管外科心血管外科
- 干预心脏病学 干预心脏病学
背景情况:
- 左脊椎动脉的重血管化对于大动脉弧2区病理至关重要.
- 它通常是间接通过关节下动脉,但直接的重血管化是异常解剖所需的.
- 直接与间接的脊椎再血管化的结果比较是必不可少的.
研究的目的:
- 为了比较直接的脊椎动脉再血管化的结果与间接的关节下动脉再血管化的结果.
- 在接受脊椎动脉再血管化的患者中确定死亡率的预测因素.
主要方法:
- 一个单一的第三级医院的回顾性队列研究 (2005-2022年).
- 与间接的关节下动脉再血管化相比,直接的脊椎再血管化.
- 分析了复合结果 (死亡,中风,神经损伤,血栓形成) 和使用后勤和考克斯回归的死亡率.
主要成果:
- 在143名患者中,有21%的患者有异常的左脊椎动脉,需要直接再血管.
- 直接重血管化显示复合结局 (42.9%与18.0%相比),旁路血栓 (33.3%与0.8%) 和声 (57.1%与18.0%) 的比率显著更高.
- 两组之间没有观察到死亡率的显著差异;年龄,住院时间和充血性心力衰竭预测死亡率.
结论:
- 直接的脊椎再血管化与复合结果,旁路血栓瘤和声的风险增加有关,特别是在异常解剖学中.
- 尽管并发症率较高,但在调整共变量后,直接再血管化并不能独立预测死亡率.
- 异常脊椎解剖的患者面临更高的并发症风险,需要仔细考虑手术方法.
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