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内血管大动脉气球控制与开放的大动脉交叉在开放的破裂的腹部大动脉动脉瘤修复
Melissa Jones1, Mark C Rockley2, Randy D Moore1
1Division of Vascular Surgery, Department of Surgery, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
Annals of vascular surgery
|July 19, 2024
概括
与在开放性手术修复 (OSR) 期间破裂腹腔大动脉动脉瘤 (rAAA) 的开放性大动脉交叉合相比,内血管大动脉气球控制没有显示出30天死亡率的显著差异. 它可能是选择患者的可行的替代方案.
科学领域:
- 血管外科 血管外科
- 手术创新 在外科创新.
- 大动脉动脉瘤管理管理
背景情况:
- 破裂的腹腔大动脉动脉瘤 (rAAA) 具有很高的死亡风险.
- 动脉交叉紧的开放外科修复 (OSR) 是一种标准的治疗方法.
- 正在探索新的内血管技术以改善结果.
研究的目的:
- 在rAAA的OSR期间,比较血管内大动脉气球控制和开放性大动脉十字之间的30天死亡率.
- 在这个关键患者群体中评估血管内大动脉气球控制的安全性和有效性.
主要方法:
- 追溯队列审查174名成年患者进行OSR,以检查红外rAAA (2001-2018).
- 21名接受血管内大动脉气球控制的患者与137名接受开放性大动脉十字的患者进行了比较.
- 多变量逻辑回归调整为手术前血压和年龄,以确定30天死亡率.
主要成果:
- 血管内大动脉气球控制与较低的死亡率 (OR 0.75,P=0.63) 有无显著关联.
- 当地麻醉与气球控制趋向于改善死亡率 (OR 0.34,P=0.19).
- 用气球控制的全身麻醉与较差的死亡率无关紧要 (OR 2.50,P=0.46).
结论:
- 在OSR期间,对rAAA的内血管大动脉气球控制和开放大动脉十字之间没有观察到30天死亡率的显著差异.
- 血管内大动脉气球控制可以作为一种替代方法,在经过OSR的精心挑选的rAAA患者中开放大动脉十字.
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