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血管内动脉动脉瘤修复后的开放性手术转换:系统性审查和元分析
Saeed S Alqahtani1, Fahad K Aljaber2, Bader Y Alsuwailem2,3
1Vascular Surgery, Charité - Universitätsmedizin Berlin, Berlin, DEU.
Cureus
|April 30, 2024
概括
在内血管动脉瘤修复 (EVAR) 后的晚期开放转换 (LOC) 在5.3%的病例中发生,通常是由于破裂或内脏泄漏. 紧急的LOC显著增加了死亡风险,强调了需要密切的EVAR后监测.
科学领域:
- 血管外科 血管外科
- 干预心脏病学 干预心脏病学
- 医疗器械技术 医疗器械技术
背景情况:
- 内血管动脉瘤修复 (EVAR) 是腹腔大动脉动脉瘤的主要治疗方法.
- 诸如内脏泄漏和移植感染等并发症可能导致晚期开放转换 (LOC).
研究的目的:
- 系统地审查和元分析EVAR后LOC的发病率,结果和相关因素.
- 评估紧急与可选LOC对患者死亡率的影响.
主要方法:
- 来自PubMed/MEDLINE,Embase和Cochrane数据库的11项研究的系统审查和元分析.
- 分析患者人口统计数据,EVAR设备,时间到LOC,转换原因和死亡率.
主要成果:
- 在分析的队列中,LOC的发病率为5.3% (79%是男性,平均年龄为73.5岁).
- 排斥器设备最频繁地与LOC相关,平均发生在EVAR后35.1个月.
- 破裂和I型内泄是紧急LOC的主要驱动因素,其死亡率比选择性LOC高10倍.
结论:
- 警的EVAR后监测对于检测需要LOC的并发症至关重要.
- 紧急LOC带来了显著更高的死亡风险,而选择性LOC的死亡率与初级开放性维修相当.
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