评估额外外动脉瘤医疗管理的安全性和有效性:一项比较性研究
Jean Filo1, Felipe Ramirez-Velandia1, Donna Lawlor2
11Neurosurgical Service, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, Massachusetts; and.
Journal of neurosurgery
|October 4, 2024
概括
对大多数额外状动脉瘤而言,医疗管理是安全的,并发症比干预更少. 在年轻患者 (≤50岁) 中,较小的伪动脉瘤 (≤6毫米) 更有可能在保守治疗下消失.
科学领域:
- 血管外科 血管外科
- 干预性放射学 干预性放射学
- 神经外科 神经外科
背景情况:
- 额外状动脉瘤越来越多地用内血管方法治疗.
- 医疗治疗是一种替代方案,但其作用和安全性需要进一步评估.
研究的目的:
- 评估干预额外状动脉瘤外瘤的指示.
- 评估这些病变的医疗管理的安全性和有效性.
主要方法:
- 对患有额外冠状动脉和脊椎伪动脉瘤的患者进行了回顾性分析.
- 分析了2006年12月至2023年6月期间来自两个中心的数据.
主要成果:
- 医疗治疗用于83%的伪动脉瘤,并发症率低 (1.9%).
- 干预 (内血管或开放手术) 与更高的并发症率 (16%) 相关.
- 预测干预的因素包括重大创伤,数字减去血管造影的使用,以及病变直径>6毫米.
- 与药物治疗 (19%) 相比,干预治疗的治愈率 (94.7%) 显著更高.
- 年龄 ≤ 50岁,最大直径 ≤ 6毫米预测成功的医疗管理 (AUC 0.87).
- 大多数患者 (98%) 在治疗后保持功能独立.
结论:
- 对于大多数额外状动脉瘤,医疗管理是安全的选择,并发症概况低于干预.
- 特定的患者和病变特征 (年龄 ≤ 50,直径 ≤ 6 mm) 预测了成功的保守治疗.
- 未解决的伪动脉瘤在医疗管理下通常保持无症状,不需要进一步的干预.
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