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结合组织疾病患者的胸内血管大动脉修复并不是一个最终的选择
Bryan D Cass1, Courtney R Hanak1, Ryan C Ellis1
1Department of Vascular Surgery, Cleveland Clinic Foundation, Cleveland, OH.
Journal of vascular surgery
|December 1, 2024
概括
结合性组织疾病 (CTD) 患者的胸内血管大动脉修复 (TEVAR) 显示了高的再干预率. 虽然最初是安全的,但TEVAR的耐用性有限,大多数并发症发生在第一年内.
科学领域:
- 心血管外科心血管外科
- 血管外科 血管外科
- 遗传学 遗传学是一种遗传学.
背景情况:
- 开放式手术是连接组织疾病 (CTD) 患者的标准.
- 胸内血管大动脉修复 (TEVAR) 只适用于紧急情况或特殊情况下.
- 关于TEVAR在CTD患者的长期疗效的数据有限.
研究的目的:
- 评估TEVAR在CTD患者中的耐用性和并发症.
- 在这个人群中评估TEVAR后的再干预率和结果.
主要方法:
- 这是一项对40名CTD患者进行的回顾性单中心研究,这些患者接受TEVAR治疗胸腔腹腔大动脉动脉瘤或剖析.
- 患者CTD包括马方综合征,洛伊斯-迪茨综合征等.
- 卡普兰-梅尔和考克斯的比例危险模型分析了再干预和转换率.
主要成果:
- 62.5%的患者需要重新干预,中位时间为9.1个月.
- 动脉瘤相关的疾病发生在TEVAR后71.1%的患者中.
- 大多数重新干预和公开转换发生在第一年内.
结论:
- 在CTD患者中,TEVAR可以安全地进行,但具有很高的并发症和重新干预的风险.
- 耐久性仍然是一个问题,经常出现晚期不良事件.
- 在CTD患者中应限制TEVAR的使用,直到可以获得改善的长期结果.
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