协奏性 Carotid 损伤的管理和治疗
Akila Pai1, Krystina N Choinski1, Christopher J Smolock1
1Division of Vascular Surgery, Icahn School of Medicine at Mount Sinai, New York, NY.
Annals of vascular surgery
|October 6, 2024
概括
这种混合方法结合了动脉内关节切除术和支架,对于双重动脉损伤是安全有效的. 需要进一步的前性研究来评估不同患者群体中风和死亡风险.
科学领域:
- 血管外科 血管外科
- 干预心脏病学 干预心脏病学
- 神经学 神经学
背景情况:
- 影响近道大动脉分支血管和动脉分叉的双重病变很少见.
- 这些病变的管理策略是多样化的,混合方法获得了突出地位.
- 这种方法涉及 carotid endarterectomy 结合常见心房动脉 (CCA) 或无名动脉 (IA) 的逆行支架.
研究的目的:
- 审查现有的关于管理双重动脉病变的文献.
- 讨论替代治疗方式.
- 突出混合方法的技术方面和结果.
主要方法:
- 通过使用Cochrane图书馆,PubMed/Medline和Embase进行了系统的文献审查.
- 关键的搜索术语集中在双重病变和混合修复策略上.
- 主要终点包括30天中风和全因死亡率;次要终点包括技术成功,复原,再干预率和1年死亡率和中风.
主要成果:
- 分析了15项涉及242名患者的回顾性研究.
- 混合方法的技术成功率高达98.8%.
- 聚合30天死亡率为1.2% (7/242),聚合30天中风率为2.9% (3/242). 平均复缩率为16.3% (34/209),主要在近端的CCA/IA,再干预率为6.2% (13/209).
结论:
- 混合方法是一种安全有效的治疗Tandem动脉疾病.
- 目前的证据主要包括单一中心研究,由于潜在的出版偏见,需要谨慎.
- 未来的注册表对于更好的风险分层中风和死亡率在无症状与症状的双重动脉病变的患者中至关重要.
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