胃肠道并发症和内脏循环变化在复杂的血管内主动脉修复过程中故意血栓塞动脉栓塞后
Arash Fereydooni1, Claudia Trogolo Franca1, Sabina M Sorondo1
1Division of Vascular and Endovascular Surgery, Department of Surgery, Stanford University, Stanford, CA.
Journal of vascular surgery
|November 28, 2024
概括
在复杂的血管内主动脉修复过程中,故意的乳房动脉栓塞 (CAE) 可能会导致14%的患者出现中枢并发症,影响长期生存. 监测CAE后的抵押品流通对于管理这些风险至关重要.
科学领域:
- 血管外科 血管外科
- 干预性放射学 干预性放射学
- 胃肠病学 胃肠病学
背景情况:
- 蓄意的动脉栓塞 (CAE) 在复杂的血管内主动脉修复中用于增强密封区.
- 经过CAE后的胃肠道并发症已被记录,但对附带循环的变化仍然不太了解.
研究的目的:
- 在复杂的内血管大动脉修复过程中,评估CAE后附带内脏循环的长期结果和适应性变化.
主要方法:
- 在12年的复杂EVAR/TEVAR期间,对70名接受CAE的患者进行了回顾性审查.
- 对术前和术后数据的分析,以识别间腔并发症,并评估并发性解剖变化.
- 多变量后勤回归以关联附带血管直径变化与介质性并发症.
主要成果:
- 14%的患者经历了90天间肠道并发症,包括胃肠道出血,,胆囊炎,胰腺炎和缺血性肝炎.
- 患有90天间肠道并发症的患者的2年生存率显著降低 (42.5%vs75.0%).
- 在CAE后的SMA和乳结处增加的附带直径与更少的并发症有关;SMA结直径的增加是保护性的 (OR 0.93).
结论:
- 在精选的EVAR病例中,CAE是海区域扩张的有价值的辅助物,但会带来介质并发症和减少长期存活的风险.
- 仔细选择患者和早期监测附带途径对于减轻CAE相关的内脏并发症至关重要.
相关概念视频
01:28Esophageal Varices-II: Clinical Features and Management
46
Esophageal varices often manifest as gastrointestinal bleeding episodes, presenting symptoms like hematemesis (vomiting of blood), hematochezia (passing fresh blood via the rectum), and melena (black, tarry stools). Other signs can include weight loss, anorexia, abdominal discomfort, jaundice, pruritus, altered mental status, and muscle cramps.
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
46
01:27Inflammatory Bowel Disease I: Ulcerative Colitis
138
Introduction
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
Risk Factors
The exact cause of IBD remains unclear, although it is believed to be due to a mix of genetic, environmental, microbial, and immune factors. Genetic factors are significant in determining susceptibility to IBD, with family history being a critical risk factor. Individuals with a first-degree relative who has IBD are at...
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
Risk Factors
The exact cause of IBD remains unclear, although it is believed to be due to a mix of genetic, environmental, microbial, and immune factors. Genetic factors are significant in determining susceptibility to IBD, with family history being a critical risk factor. Individuals with a first-degree relative who has IBD are at...
138