不复杂的B型大动脉剖析:一个欧洲多中心的截面评估
Mohamad Bashir1, Matti Jubouri2, Abdelaziz O Surkhi3
1Neurovascular Research Laboratory, Faculty of Life Sciences and Education, University of South Wales, Pontypridd, UK.
Annals of vascular surgery
|December 20, 2024
概括
不复杂的B型大动脉解剖 (uTBAD) 管理在欧洲各不相同. 预防性胸内血管大动脉修复 (TEVAR) 越来越多地被推用于高风险病例,但需要更多的试验证据.
科学领域:
- 血管外科 血管外科
- 大动脉疾病 大动脉疾病
- 干预心脏病学 干预心脏病学
背景情况:
- 欧洲非复杂型B型大动脉修复 (EU-TBAR) 试验正在开发,以比较预先性胸腔内血管大动脉修复 (TEVAR) 与定制设备与最佳医疗治疗.
- 试验前设置涉及评估欧洲活动,趋势,治理,结果报告和不复杂的B型大动脉剖析 (uTBAD) 的成本效益.
- 本研究介绍了欧洲各中心关于uTBAD风险评估,活动,实践和治理的观察调查结果.
研究的目的:
- 评估目前欧洲非复杂型B型大动脉剖析 (uTBAD) 管理的情况.
- 突出 uTBAD 的风险评估策略,临床实践和治理结构.
- 为EU-TBAR随机对照试验的设置和目标提供信息.
主要方法:
- 一个使用问卷的观察性,横截面的欧洲调查.
- 收集关于理解,风险评估,地方治理和与uTBAD相关的临床活动的数据.
- 数据管理和收集使用了研究电子数据捕获 (REDCap).
主要成果:
- 来自14个欧洲国家的43名外科医生中有37名 (86%) 回答了.
- 大多数中心报告每年 uTBAD 遇到的情况较低;秋季是最常见的季节.
- 43.2%的参与者推先发性TEVAR,偏爱亚急性时间. 快速大动脉扩大是最关键的风险因素. 戈尔TAG是最常用的设备,在73%的中心提供定制设备. 大多数中心都有协议和多学科团队,但只有45.9%的中心将服务转移到专门的中心.
结论:
- 不复杂的B型大动脉剖析 (uTBAD) 是一种需要早期诊断和干预的动态疾病.
- 对高风险uTBAD的预防性TEVAR正在获得引力,可能扩大适应症.
- 进一步的大规模欧洲协作随机对照试验对于确定uTBAD最佳外科手术管理至关重要.
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