逆行开放的中腔体支架和急性中腔体缺血的结果
Maraya Camazine1, Chase Schesselman2, Iris Zachary3,4
1Department of Surgery, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
Vascular
|August 27, 2024
概括
逆行开放的中腹膜支架 (ROMS) 与开放的旁路或栓塞切除相比,在急性中腹膜缺血患者中显著降低了死亡率. 这种新技术在紧急情况下显示出它是恢复中腔体流动的优质替代方案.
科学领域:
- 血管外科 血管外科
- 干预心脏病学 干预心脏病学
- 胃肠病学 胃肠病学
背景情况:
- 有限的数据存在于逆向的开放性介质支架 (ROMS) 对于急性介质缺血.
- 现有的研究规模小,单一中心,缺乏明确的结果.
- 患者群体和ROMS的使用情况差异很大.
研究的目的:
- 评估患有急性介质缺血需要紧急手术干预的患者的特征和结果.
- 为了将ROMS与传统的开放式旁路和开放式上层中枢动脉 (SMA) 栓塞术进行比较.
- 为了确定与急性介质缺血的死亡率相关的因素.
主要方法:
- 使用国家住院样本 (NIS) 数据库 (2018-2020) 进行回顾性队列研究.
- 包括898名因中肠缺血症接受紧急手术的患者.
- 组:开放的绕道 (BYPASS),开放的SMA栓塞切除术 (OPEN) 和ROMS. 统计分析包括t测试,奇平方和多变量回归.
主要成果:
- ROMS患者年龄较大,并具有较高的并发症评分,但与BYPASS (19.7%) 和OPEN (34.5%) 相比,死亡率最低 (15.9%).
- 罗姆斯与50%的死亡率降低相关 (OR 0.45).
- 开放性SMA栓塞切除 (OR 2.0) 和先前的心肌梗塞 (OR 1.9) 增加了死亡率,而外周血管疾病 (PVD) 显示出保护作用 (OR 0.56).
结论:
- 罗姆斯在急性介质缺血症的传统开放手术中显示出显著的死亡率优势.
- 高龄,心脏病史和开放的SMA栓塞术与死亡率增加有关.
- 在急性情况下,ROMS可能是恢复中腔流的优质替代方案,这需要进一步的前性研究.
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