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在的胸前动脉损伤后创伤性胸前动脉缩要求出现的胸前内血管动脉修复

Maunil N Bhatt¹, Saskya Byerly², Dina M Filiberto²

¹Division of Vascular and Endovascular Surgery, University of Tennessee Health Science Center, Memphis, TN.

Annals of surgery

|June 12, 2024

概括

推使用创伤性胸前动脉缩 (TTAC) 的胸前动脉损伤 (BTAI) 的紧急修复. 在TTAC患者中,延迟修复会增加输血风险和死亡率.

科学领域:

心血管外科心血管外科
创伤外科手术创伤外科
诊断成像诊断成像诊断成像

背景情况:

有限的文献存在于粗胸前动脉损伤 (BTAI) 后的 malperfusion 综合征.
胸内血管大动脉修复 (TEVAR) 在BTAI患者的最佳时机仍未确定.

研究的目的:

在BTAI患者中识别对perfusion综合征的临床和成像预测因素.
评估TEVAR时间对BTAI患者结果的影响.

主要方法:

对从BTAI患者收集的前性数据的回顾性分析 (2021年1月至2023年10月).
临床的评估,胸前大动脉成像,TEVAR的时间,死亡率和阻 perfusion/reperfusion后果.
临床/成像发现,TEVAR时间和患者结果之间的相关性分析.

主要成果:

在13,717名伤患者中,77% (0.6%) 患有BTAI;42人接受了TEVAR.
七名患者 (9.1%) 患有创伤性胸前大动脉缩 (TTAC),光线缩小>50%,脉减弱.
与非TTAC BTAI患者 (5.8%) 相比,TTAC患者经历了perfusion/reperfusion后续,在医院内死亡率较高 (29%).

结论:

患有TTAC的患者在TEVAR延迟时面临阻 perfusion/reperfusion后续的高风险.
建议使用TTAC紧急修复BTAI以防止不良结果.
对TTAC病例的早期干预可以减轻严重并发症并降低死亡率.

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