在TAVI后伪动脉瘤的重要性 - 对2063名患者的回顾性分析
Patricia Wischmann1,2, Manuel Stern1, Sven Baasen1
1Division of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany.
VASA. Zeitschrift fur Gefasskrankheiten
|July 17, 2024
概括
伪动脉瘤 (PSA) 是通过导管的大动脉植入 (TAVI) 后的一种并发症. 二次接入和抗凝药是危险因素,但PSA可以安全治疗,不会影响一年死亡率.
科学领域:
- 心脏病学 心脏病学
- 血管外科 血管外科
- 干预心脏病学 干预心脏病学
背景情况:
- 双腿动脉接入是通过导管的大动脉植入 (TAVI) 的标准.
- 伪动脉瘤 (PSA) 是已知的股骨动脉穿刺的并发症,但其发生率和TAVI后的影响还没有得到很好的描述.
- 记录了TAVI后的主要血管并发症,但PSA的具体数据仍然有限.
研究的目的:
- 为了确定PSA的发病率后的骨输血TAVI.
- 为了确定与PSA发展相关的风险因素.
- 评估与PSA相关的治疗结果和长期死亡率.
主要方法:
- 在2014年1月至2020年1月期间,对2063名患者进行了体输血TAVI的回顾性分析.
- 在TAVI之前和之后,对共同的股骨动脉进行血管超声波评估.
- 患者特征,手术数据和PSA和无PSA患者之间的结果的比较,包括VARC-3标准,停留时间和一年死亡率.
主要成果:
- 在TAVI后PSA的发病率为2.2% (46/2063).
- PSA 的危险因素包括二次接入部位和非维生素K 抗剂口服抗凝剂 (NOAC) 治疗.
- PSA 与接触部位出血增加和停留时间延长有关,但没有影响一年死亡率.
结论:
- 伪动脉瘤是TAVI后的重大并发症,与进入部位出血和延长住院时间有关.
- 二次接入和NOAC治疗被确定为PSA的关键风险因素.
- 超声导向血注射为TAVI相关的PSA提供了安全有效的治疗方法,对一年的存活率没有不利影响.
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