控制高血压与不受控制的高血压对动脉复血管化手术的结果的影响
Marc Farah1, Marjan Moghaddam2, Sina Zarrintan2
1Georgetown University School of Medicine, Washington, DC.
Journal of vascular surgery
|May 19, 2024
概括
不受控制的高血压 (uHTN) 增加了脑卒中和死亡风险,在心动脉再血管化后. 横冠状动脉支架 (TFCAS) 显示出更糟糕的结果,而冠状动脉内关节切除术 (CEA) 和横冠状动脉再血管化 (TCAR) 是 uHTN 患者的更安全的选择.
科学领域:
- 血管外科 血管外科
- 心血管医学 心血管医学
- 临床结果研究研究
背景情况:
- 高血压 (HTN) 是血管手术中不良结果的已知危险因素.
- 关于不受控制的HTN (uHTN) 对动脉复血管化结果的影响的数据有限.
研究的目的:
- 在患有uHTN的患者中,比较心动脉内关节切除术 (CEA),脑膜转移性心动脉支架 (TFCAS) 和跨心动脉复血管化 (TCAR) 的结果.
- 确定 uHTN.N.患者最安全的重血管化策略.
主要方法:
- 从2020年4月到2022年6月,对34653名CEA,8199名TFCAS和17309名TCAR患者进行了回顾性分析.
- 根据血压和药物治疗,患者被分为受控HTN (cHTN) 和不受控制HTN (uHTN) 组.
- 主要结局包括住院中风,死亡,心脏病发作和30天死亡率;次要结局评估了术后并发症和住院时间.
主要成果:
- 与cHTN相比,患有uHTN的患者在所有手术中都有更多的并发症,并增加了中风/死亡/心脏病发作的风险.
- uHTN与所有方法的长时间停留 (LOS) 相关.
- 在uHTN患者中,TFCAS对中风,死亡和再输综合征的风险高于CEA.
结论:
- 患有uHTN的患者面临更高的术后中风和死亡风险,强调手术前的HTN管理.
- 与TFCAS相比,TCAR和CEA在患有uHTN的患者中显示出更好的结果.
- 推CEA和TCAR作为UHTN患者的更安全的干预措施,需要进行大脑动脉再血管.
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