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在接受以烟技术修复大动脉动脉瘤的患者中发生上大动脉血栓
Filippo Benedetto1, Domenico Spinelli1, Chiara Barillà1
1Division of Vascular Surgery, School of Medicine, University of Messina, Messina, Italy.
概括
在上大动脉中严重的壁面血栓增加了在腹腔大动脉动脉瘤修复 (ChEVAR) 中烟移植后的并发症. 术前对血栓严重性的评估可以帮助为接受ChEVAR的患者量身定制治疗策略和随访.
科学领域:
- 血管外科 血管外科
- 血管内修复 血管内修复
- 大动脉动脉瘤治疗方法
背景情况:
- 腹腔大动脉动脉瘤修复中的烟移植 (ChEVAR) 是不适合进行开放式手术或定制窗口内移植的患者的选择.
- 切瓦后的再干预率在3年内接近20%,需要确定并发症的危险因素.
- 上大动脉的壁面血栓是一种潜在的风险因素,需要进一步调查.
研究的目的:
- 评估上大动脉壁血栓对切沃后的外科手术和随访并发症的影响.
- 为了确定墙壁血栓的严重程度是否预测了接受ChEVAR的患者的不良结果.
主要方法:
- 对2015年至2022年间连续接受ChEVAR治疗的患者进行了回顾性研究.
- 收集的数据包括目标血管的数量,支架移植的尺寸,以及壁面血栓的存在/严重程度 (得分为0-10).
- 分析了术后和后续并发症,包括内脏泄漏,烟支架问题和功能变化.
主要成果:
- 31名患者接受了ChEVAR;13%的患者经历了1A型内脏泄漏,23%的患者患有烟支架并发症,26%的患者显示功能恶化.
- 在2年内,患有严重壁血栓的患者从切沃相关并发症中自由度明显降低 (28%对59%,p=0.023).
- 总体生存率在2年时为90%.
结论:
- 副大动脉中严重的壁面血栓与切沃相关并发症的增加有关.
- 在手术前评估壁状血栓的严重程度,可以指导手术策略和患者的随访.
- 需要对更大的队列进行进一步的研究来证实这些发现.
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