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可选的开放修复与脱枝, perfuse,重建技术来治疗上腺或IV型胸腔腹腔大动脉动脉瘤

Thibaud Hamelin¹, Zakariyae Bouziane¹, Nicla Settembre²

¹Department of Vascular Surgery, Nancy Regional University Hospital, Nancy, France.

Journal of vascular surgery

|August 24, 2024

概括

新的脱枝, perfuse,重建 (DPR) 技术提供了一个安全有效的方法,用于开放的手术修复上腹腔大动脉动脉瘤 (SRAAA) 和IV型胸腔腹腔大动脉动脉瘤 (TAAA),最大限度地减少缺血并发症.

科学领域:

血管外科血管外科
大动脉动脉瘤修复修复
最少侵入性的技术

背景情况:

由于手术内内脏和缺血症,SRAAA和TAAA的开放性手术修复存在挑战.
新的脱枝, perfuse,重建 (DPR) 技术利用脱枝和被动动脉分流来缓解缺血症并发症.

研究的目的:

评估SRAAA和TAAA修复的DPR技术的30天和1年的死亡率.
评估DPR技术对功能和动脉通透性的影响.

主要方法:

以 DPR 技术进行选择性 SRAAA 或 TAAA 修复的 40 名患者的回顾性研究 (2011 年 1 月至 2022 年 6 月).
DPR技术涉及使用多分支移植进行脱枝,通过管进行 perfusion,并使用移植进行大动脉修复.
对临床,放射和生物数据的分析,包括并发症,再干预和动脉通透性.

主要成果:

通过DPR技术,30天和1年死亡率较低 (2.5%).
观察到低率的呼吸道 (5%) 和中肠道缺血并发症 (7%);没有心脏或脊髓功能障碍.
对于乳干 (95%),SMA (100%),左动脉 (90%),右动脉 (100%) 绕道,在功能没有显著变化的情况下,获得了优异的1年通透率.

结论:

在开放的SRAAA和TAAA修复过程中,DPR技术提供了短的内脏和脏缺血时间.
这种方法是开放性大动脉动脉瘤手术中内脏和脏保护的可行选择.

关键词:

腹腔大动脉动脉瘤腹腔大动脉动脉瘤开放式维修开放式维修结果研究研究结果研究.胸腔腹腔动脉瘤是一种动脉瘤.

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