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基于病因的胸内血管大动脉修复的长期结果:一个单一中心的经验

Akitoshi Takazawa¹, Toshihisa Asakura², Ken Nakazawa³

¹Department of Cardiovascular Surgery, Saitama Medical University International Medical Center, Yamane, Hidaka City, Saitama, 1397-1, Japan. a.takazawa.cvs@gmail.com.

Heart and vessels

|April 9, 2024

概括

胸内血管大动脉修复 (TEVAR) 对胸大动脉动脉瘤 (TAA) 和斯坦福B型大动脉剖析 (TBAD) 显示出令人满意的短期结果. 然而,长期结果显示出病因特异性的并发症,TBAD需要更多的重新干预.

科学领域:

心血管外科心血管外科
血管外科血管外科
血管内干预血管内干预

背景情况:

胸内血管大动脉修复 (TEVAR) 越来越多地用于胸大动脉动脉瘤 (TAA) 和斯坦福B型大动脉剖析 (TBAD).
基于病因 (TAA与TBAD) 的TEVAR的长期结果尚未被彻底探讨.

研究的目的:

调查和比较TEVAR对TAA和TBAD的病因特异性的长期结果.
为了确定TAA和TBAD患者与TEVAR治疗之间的并发症和再干预率的差异.

主要方法:

在2007年7月至2021年12月期间进行的421次TEVAR手术的回顾性分析.
包括249个TAA病例和172个TBAD病例;不包括创伤性大动脉解剖和损伤.
平均随访时间为5.7年;评估的30天死亡率,中风,,大动脉相关死亡率和再干预率.

主要成果:

总体30天死亡率为1.4%;中风发病率为0.9%;残肢发生在1.7%的患者中.
在TAA和TBAD组之间,无大动脉相关死亡的自由度没有显著差异.
胸部再干预在TBAD组中明显更常见 (p=0.003),内泄作为主要指示.

结论:

对于TAA和TBAD,TEVAR的外科结果都是令人满意的.
长期结果受到病因特异性并发症的影响,需要仔细监测.
在TBAD中更高的再干预率凸显了TEVAR后需要针对病因学特定的管理策略的需要.

关键词:

病理起因病理起因病理起因长期的结果.斯坦福B型大动脉剖析胸前大动脉动脉瘤胸前大动脉动脉瘤胸内血管大动脉修复

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