切割后的胸腔腹腔大动脉动脉瘤是通过窗口或分支的内血管大动脉修复来管理的
Filippo Gorgatti1, Petroula Nana1, Giuseppe Panuccio1
1German Aortic Centre, Department of Vascular Medicine, University Heart and Vascular Centre UKE Hamburg, Hamburg, Germany.
概括
在切割后慢性胸腔腹腔大动脉动脉瘤 (PD-TAAA) 中,窗口或分支内血管大动脉修复 (F/B-EVAR) 显示出高的技术成功. 然而,脊髓损伤率仍然很高,近一半的患者需要在24个月内重新进行干预.
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:
- 慢性剖析后胸腹大动脉动脉瘤 (PD-TAAA) 存在复杂的治疗挑战.
- 窗体或分支内血管大动脉修复 (F/B-EVAR) 是这些患者的一个新兴选择.
研究的目的:
- 分析F/B-EVAR在PD-TAAA患者的早期和随访结果.
- 评估技术成功,死亡率,重大不良事件和重新干预率.
主要方法:
- 连续八年使用F/B-EVAR治疗的PD-TAAA患者的回顾性分析.
- 包括使用F/B-EVAR管理的所有符合条件的患者,使用修改后的克劳福德分类.
- 使用卡普兰-梅尔分析分析30天死亡率,重大不良事件 (MAE),脊髓损伤 (SCI) 和长期存活率.
主要成果:
- 在55名患者中的96% (平均年龄为63.7岁) 取得了技术上的成功.
- 30天死亡率为7%,MAE率为20%,SCI率为13% (2% 3级),尽管进行了预防性脑脊髓液排水.
- 在24个月后,生存率为86%,无需重新干预的自由率为55%,在F-EVAR中目标血管通透率高于B-EVAR.
结论:
- F/B-EVAR显示了PD-TAAA的高技术成功和可接受的早期结果.
- 尽管采取了预防措施,脊髓损伤仍然是一个重大问题 (>10%).
- 近一半的患者需要在F/B-EVAR后24个月内重新进行非预定的干预.
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