在接受动脉再血管化的贫血患者的术后结果
Ahmed Abdelkarim1, Sabrina L Straus1, Marjan Moghaddam1
1Division of Vascular & Endovascular Surgery, Department of Surgery, Center for Learning and Excellence in Vascular and Endovascular Surgery, UC San Diego, San Diego, CA.
Journal of vascular surgery
|August 23, 2024
概括
穿动脉再血管化 (TCAR) 显示,在接受动脉手术的贫血患者中,结果有所改善. 与输血尾动脉支架 (TFCAS) 和尾动脉内关节切除术 (CEA) 相比,TCAR与较低的死亡率和主要心脏不良事件有关.
科学领域:
- 血管外科 血管外科
- 心血管干预 心血管干预
- 贫血管理 贫血管理
背景情况:
- 手术前贫血是主要血管手术后不良结果的已知危险因素.
- 对贫血患者的最佳动脉再血管化策略仍未得到充分研究.
- 这项研究探讨了在贫血患者中不同动脉复血管化方法的比较有效性.
研究的目的:
- 在患有贫血的患者中,比较30天死亡率和医院内主要不良心脏事件 (MACE) 后,心动脉内关节切除术 (CEA),脑膜转移性心动脉支架 (TFCAS) 和跨心动脉再血管化 (TCAR).
- 为贫血患者确定最安全,最有效的动脉再血管化技术.
主要方法:
- 血管质量倡议数据库 (2016-2023) 的回顾性分析.
- 包括患有贫血的患者,定义为血红蛋白<13 g/dL (男性) 或<12 g/dL (女性).
- 多变量逻辑回归模型被用来分析主要结果:30天死亡率和住院MACE.
主要成果:
- 这项研究分析了贫血患者的40383例CEA,9159例TFCAS和18555例TCAR病例.
- 与TFCAS相比,TCAR的30天死亡率 (aOR 0.45) 和MACE (aOR 0.58) 显著降低.
- 与CEA相比,TCAR显示了较低的30天死亡率 (aOR 0.80) 的趋势,MACE率相似.
- 与CEA相比,TFCAS与30天死亡率 (aOR 2.0) 和MACE (aOR 1.7) 的增加有关.
结论:
- 与CEA和TCAR相比,在贫血患者中,跨关节动脉支架 (TFCAS) 与较高的死亡和MACE风险有关.
- 与CEA相比,在这个人群中,跨动脉再血管化 (TCAR) 提供了较低的30天死亡风险.
- 在患有贫血的患者中,TCAR成为潜在的最佳最小侵入性选项,用于动脉复血管化.
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