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烟支架与巴西利卡用于预防跨导管大动脉置换期间的急性冠状动脉阻塞

Antonio Mangieri¹, Ines Richter², Mauro Gitto³

¹IRCCS Humanitas Research Hospital, Rozzano-Milan, Italy.

JACC. Cardiovascular interventions

|March 27, 2024

概括

烟支架和生物假体或本地大动脉贝故意撕裂以防止阳性冠状动脉阻塞 (BASILICA) 能够有效地预防跨导管大动脉置换期间的冠状动脉阻塞. 这两种方法在一年后显示出相似的安全性和有效性.

科学领域:

心血管干预心血管干预
结构性心脏病结构性心脏病
干预心脏病学干预心脏病学

背景情况:

冠状动脉阻塞 (CO) 是通过导管的大动脉置换 (TAVR) 后的一种严重并发症.
预防策略,如烟支架和BASILICA已经开发,以减轻CO的风险.
确定最佳的预防技术对于TAVR患者的安全至关重要.

研究的目的:

为了比较烟支架与BASILICA的周围手术和一年临床结果.
评估这些技术在高风险的TAVR患者中对CO敏感的有效性.
评估两种不同的二氧化碳预防策略的安全性和有效性.

主要方法:

一个多中心观察注册表包括高风险的TAVR患者.
患者接受了预防性烟支架或BASILICA.
主要终点:在一年内发生主要的不良心血管事件 (死亡,心脏病发作,中风,再血管).

主要成果:

分析了168名患者:其中71名 (42.3%) 是烟,97名 (57.7%) 是巴西利卡.
巴西利卡患者的基线CO风险较高 (下阴管结高度/直径).
临床成功率相似 (97.2%的烟与96.9%的巴西利卡). 一年的MACE发病率是可比的 (18.7%的烟与19.9%的巴西利卡).

结论:

烟支架和BASILICA都有效地预防TAVR期间的急性冠状动脉阻塞.
这些技术显示了可比和可接受的周边程序和一年的结果.
烟和BASILICA之间的选择可能取决于患者特定的解剖学因素和程序考虑.

关键词:

烟支架是为了支架烟.冠状动脉阻塞冠状动脉阻塞传单的修改传单的修改浮潜器支架的插入.通过导管更换大动脉门.

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