皮肤深静脉动脉化的有效性和持久性:系统性审查
Samuel E So1, Yiu Che Chan1, Stephen W Cheng1
1Division of Vascular & Endovascular Surgery, Department of Surgery, University of Hong Kong Medical Centre, Queen Mary Hospital, Hong Kong SAR, China.
Annals of vascular surgery
|April 5, 2024
概括
血管内深静脉动脉化 (DVA) 对没有选择的关键四肢缺血症 (NO-CLI) 患者来说是有前途的,技术上的成功率很高,但截肢率很高. 需要进一步的研究来确定常规使用.
科学领域:
- 血管外科 血管外科
- 干预心脏病学 干预心脏病学
- 再生医学是一种再生医学.
背景情况:
- 对于那些无法接受传统手术的患者来说,对外周动脉疾病 (PAD) 的管理仍然具有挑战性.
- 内血管深静脉动脉化 (DVA) 在这种情况下为肢体救援提供了一种新的方法.
- 本综述综合了目前关于DVA在无选择性关键四肢缺血症 (NO-CLI) 的有效性和安全性的证据.
研究的目的:
- 系统地审查对NO-CLI的内血管DVA的当代文献.
- 评估与DVA相关的技术成功,截肢率,伤口愈合,并发症,再干预和死亡率.
主要方法:
- 在遵守PRISMA指南的基础上进行系统审查.
- 在PubMed,Web of Science,OvidSP和Embase进行的关于皮肤通道深静脉动脉化的研究的搜索.
- 纳入标准:包括≥5名患者的研究,不包括开放或混合DVA;主要结果:技术成功率和截肢率;次要结果:伤口愈合,并发症,重新干预和死亡率.
主要成果:
- 分析了10项涉及233名NO-CLI患者的研究,平均随访时间为12个月.
- 技术成功率高 (97%),但主要截肢率为21.8%.
- 报告的伤口愈合率为69.5%,并发症率为13.8%,再干预率为37.4%,全因死亡率为15.7%.
结论:
- 内血管DVA似乎对NO-CLI患者是安全的.
- 然而,目前的研究规模较小,随访时间有限 (<1年).
- 缺乏1级证据来支持对NO-CLI的常规DVA实施.
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