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在复杂和胸腔腹腔大动脉动脉瘤治疗中使用外科医生修改的移植的全国趋势

Thomas F X O'Donnell¹, Kirsten D Dansey², Marc L Schermerhorn³

¹Division of Cardiac, Thoracic, and Vascular Surgery, New York-Presbyterian/Columbia University Irving Medical Center/Columbia University Vagelos College of Physicians & Surgeons, New York, NY.

Journal of vascular surgery

|February 14, 2024

概括

医生修改的内脏移植 (PMEG) 现在是美国复杂的大动脉动脉瘤修复的领先方法,超过了标准的窗口内血管移植. 建议对PMEG技术和结果进行更广泛的共享,以促进内血管大动脉手术的进展.

科学领域:

血管外科血管外科
血管内主动脉修复血管内主动脉修复
大动脉动脉瘤管理管理

背景情况:

在美国,定制分支/窗口移植的有限可用性需要替代策略.
医生修改的内移植 (PMEG) 已经成为复杂的大动脉动脉瘤修复的关键替代方案.
该研究调查了与标准设备相比,PMEG利用的流行率和趋势.

研究的目的:

确定医生修改的内移植 (PMEGs) 在复杂的大动脉动脉瘤修复中的广泛采用.
分析使用PMEGs与标准窗体内血管移植 (ZFENs) 的时间趋势.
为了根据动脉瘤复杂性和外科医生的体积来比较利用模式.

主要方法:

来自血管质量倡议 (2014-2022) 的复杂内血管大动脉动脉瘤修复的分析.
检查ZFEN,PMEG和并行移植技术的使用时间趋势.
根据动脉瘤位置 (右侧,胸腔腹部) 和外科医生病例量数据的分层.

主要成果:

医生修饰内移植 (PMEG) 的使用量显著增加,在2021年超过2:1超过ZFEN.
PMEG的利用率稳步上升,而ZFEN的使用率停滞不前,特别是在对接性和复杂的维修中.
大量的外科医生主要使用PMEG,这表明复杂的内血管修复策略的转变.

结论:

医生修改的内脏移植 (PMEG) 已成为在研究试验之外的复杂大动脉动脉瘤修复的主要方式.
该研究强调了对PMEGs的越来越多的依赖,以挑战正侧脉和胸腔腹腔大动脉动脉瘤.
更广泛地传播PMEG技术和结果对于推动内血管大动脉外科手术至关重要.

关键词:

腹腔大动脉动脉瘤腹腔大动脉动脉瘤复杂的内血管动脉瘤修复复合.埃瓦尔·埃瓦尔 (Evar Evar) 是一个人.发烧,就是发烧.有窗口的内脏移植.医生修改的内脏移植.

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