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A New Murine Model of Endovascular Aortic Aneurysm Repair
Published on: July 7, 2013
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评估内血管动脉瘤修复的有效性和临床结果 - - 日本对破裂腹腔大动脉动脉瘤的第一种方法
Hidemitsu Ogino1, Naoko Isogai2, Nao Kume1
1Department of Vascular Surgery, Narita Tomisato Tokushukai Hospital, Chiba, Japan.
概括
与开放式手术相比,内血管动脉瘤修复 (EVAR-first) 策略显著降低了腹腔大动脉动脉瘤破裂 (rAAA) 的30天死亡率. 这种方法可以提高生存率,支持EVAR作为rAAA.的主要治疗选择.
科学领域:
- 血管外科 血管外科
- 大动脉动脉瘤治疗方法
- 血管内干预 血管内干预
背景情况:
- 破裂腹腔大动脉动脉瘤 (rAAA) 仍然是一个危及生命的疾病,死亡率高.
- 传统的开放性手术修复带有重大风险.
- 在日本,对rAAA的内血管动脉瘤修复 (EVAR-first) 策略的有效性需要验证.
研究的目的:
- 评估日本治疗rAAA的EVAR-first策略的有效性和结果.
- 为了比较基于Shonan rAAA协议 (SRAP) 的EVAR-first策略与开放性手术治疗的有效性.
主要方法:
- 一项对2007年至2016年期间在日本三家医院接受治疗的163名rAAA患者的比较研究.
- 两个组:开放的外科治疗 (追溯) 和EVAR-first策略 (前性,SRAP协议).
- 短期和长期结果进行了比较,包括使用风险评分进行匹配的队列分析.
主要成果:
- 与开放手术组 (42%) 相比,EVAR-first组的30天死亡率明显较低 (25%).
- 在匹配的队列中,EVAR-first的30天死亡率为22%,而开放手术的44%.
- 在匹配的队列中,EVAR-first在6个月,1年和3年后改善了术后生存率 (p=0.003).
结论:
- 与开放手术相比,基于SRAP的EVAR-first对rAAA的策略显著改善了治疗结果.
- 对于rAAA患者来说,EVAR-first与减少早期死亡率和更好的长期存活率有关.
- 这些发现支持考虑EVAR作为rAAA的主要治疗选择,以改善患者的治疗结果.
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