患有急性B型大动脉剖析和高风险特征的患者的结果
Jonathan R Krebs1, Amanda C Filiberto1, Brian Fazzone1
1Division of Vascular Surgery and Endovascular Therapy, Department of Surgery, University of Florida, Gainesville, FL.
Annals of vascular surgery
|April 4, 2024
概括
高风险特征在急性B型大动脉解剖 (TBAD) 中很常见. 患有高风险TBAD的患者通过胸内血管大动脉修复 (TEVAR) 进行治疗,与接受TEVAR的复杂TBAD患者相比,结果有所改善.
科学领域:
- 心血管外科心血管外科
- 血管外科 血管外科
- 胸部外科手术 胸部外科手术
背景情况:
- 当代的指导方针定义了复杂的,不复杂的,高风险的急性B型大动脉解剖 (TBAD).
- 很少有研究专门评估高风险TBAD的结果.
- 这项研究评估了高风险的TBAD与胸内血管大动脉修复 (TEVAR) 管理的结果与最佳医疗管理.
研究的目的:
- 为了比较高风险的TBAD患者的人口统计,临床表现和结局,这些患者接受了TEVAR或医疗管理.
- 将这些结果与复杂和无并发性TBAD患者进行比较.
- 评估高风险特征对TBAD管理和患者治疗结果的影响.
主要方法:
- 2011年10月至2020年3月期间对159名急性TBAD患者的分析.
- 根据STS/SVS 2020指南将TBAD分类为高风险,复杂 (C-TBAD) 和不复杂的TBAD组.
- 主要终点:住院患者死亡率;次要终点:并发症,重新干预和存活率.
主要成果:
- 63%的患者符合高风险标准;40%有C-TBAD;33人没有并发症的TBAD.
- 与HR-TEVAR相比,C-TBAD患者住院时间较长,恢复时间较短.
- 对于C-TBAD,3年生存率较差,但在不包括住院死亡率的各组中相似.
结论:
- 高风险特征在急性TBAD中普遍存在,需要谨慎管理.
- 对于高风险的TBAD,手术 (TEVAR) 和医疗管理都取得了可接受的结果.
- 与C-TBAD的TEVAR相比,高风险TBAD的TEVAR显示出更好的术后结果和死亡率.
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