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内移植血栓作为内血管动脉瘤修复后开放转换的标志在25年多的多中心实验中

Anna Fornasari¹, Paolo Perini², Mauro Gargiulo³

¹Vascular Surgery, Department of Medicine and Surgery, University of Parma, Parma, Italy.

Annals of vascular surgery

|June 29, 2024

概括

在EVAR后对大动脉内移植血栓的开放转换是复杂的,通常需要上关和完全切除支架移植,导致高短期死亡率.

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:

大动脉内移植血栓形成 (AET) 可能需要在血管内大动脉动脉瘤修复 (EVAR) 后进行开放转换 (OC).
多中心数据对于理解EVAR后的OC对AET的结果至关重要.

研究的目的:

描述AVAR后对大动脉内移植血栓形成的开放转换的结果.
分析这个复杂的程序的短期和长期结果.

主要方法:

在12个意大利中心 (1997-2022) 进行AETOC治疗的16名患者的回顾性分析.
评估30天死亡率,术后并发症,生存率和主动脉相关并发症.
数据包括重建的类型和需要上关的需要.

主要成果:

16名患者 (平均年龄68.6岁) 接受了AET的OC,EVAR后的中位数为26.46个月.
50%的患者需要进行上关;75%的患者需要完全切除支架移植.
30天死亡率为12.5%,整体发病率为43.8%. 估计的1,2年和3年生存率分别为80.4%,62.5%和41.7%.

结论:

对AET的开放转换只适用于不适合内血管修复的复杂病例.
上关和完全切除内移植与高短期死亡率有关.
谨慎的患者选择和手术规划对于管理EVAR后的AET至关重要.

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