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管理一次性大动脉壁血栓的挑战:结果和技术考虑
Daniel Mendes1,2, Carlos Veiga3, Rui Machado1,2
1Department of Angiology and Vascular Surgery, Centro Hospitalar Universitário de Santo António, Porto, Portugal.
概括
主要大动脉壁血栓 (PAMT) 的管理具有挑战性. 仅抗凝治疗就有很高的复发率,而胸内血管大动脉修复可以防止进一步的栓塞,但需要明确的标准.
科学领域:
- 血管外科 血管外科
- 心脏病学 心脏病学
- 干预性放射学 干预性放射学
背景情况:
- 主要大动脉壁血栓 (PAMT) 可以导致严重的并发症,如多动脉栓塞.
- 对PAMT的最佳管理策略仍未确定,这带来了重大的临床挑战.
研究的目的:
- 描述治疗PAMT患者的临床经验和结果.
- 评估PAMT不同治疗方式的有效性.
主要方法:
- 2015年1月至2021年12月期间被诊断患有PAMT的13名患者的回顾性审查.
- 收集的数据包括人口统计,风险因素,成像 (CTA),临床表现,治疗和结果 (复发,截肢,死亡).
主要成果:
- 大多数患者 (92%) 患有胸部PAMT,并呈现急性四肢缺血症 (85%).
- 所有患者都开始服用抗凝药; 54%的患者出现了复发. 两名患者接受了内血管支架移植修复.
- 在39个月的中位数随访期间,发生了一起与PAMT相关的死亡和一个重大截肢.
结论:
- 抗凝药单独可以解决PAMT,但具有高血栓复发率.
- 胸内血管大动脉修复是防止进一步栓塞的可行选择,但其作为一线治疗的作用需要进一步定义.
- 密切监测患者对于管理PAMT至关重要.
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