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Updated: May 4, 2026

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A New Murine Model of Endovascular Aortic Aneurysm Repair
Published on: July 7, 2013
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从1区到3区:在A型大动脉剖析中复杂的内血管大动脉修复的可行性和安全性
Justin A Robinson1, Aakash Shah1, Diljan Chahal1
1University of Maryland School of Medicine, Division of Cardiothoracic Surgery.
The Journal of thoracic and cardiovascular surgery
|January 17, 2025
概括
血管内修复对高风险急性甲型大动脉剖析患者有希望,可接受的早期死亡率和中风率. 然而,内脏泄漏很常见,特别是在大动脉根部附近,影响长期生存.
科学领域:
- 心血管外科心血管外科
- 干预心脏病学 干预心脏病学
- 血管医学 血管医学
背景情况:
- 急性A型大动脉剖析 (aTAAD) 具有显著的风险,超过30%的患者被认为是高风险或无法进行传统开放手术的患者.
- 确定高风险aTAAD患者的有效治疗策略对于改善结果至关重要.
研究的目的:
- 为了评估复杂的内血管大动脉修复 (EVAR) 的早期和中期结果,在患有aTAAD的患者中,这些患者面临开放手术的高风险.
- 在这个具有挑战性的患者群体中,评估EVAR对大动脉根,上升大动脉和大动脉卷入的安全性和有效性.
主要方法:
- 一组29名高风险患者在2018年1月至2023年1月期间接受了EVAR.
- 程序包括孤立的上升式支架移植,Endo-Bentall用于大动脉根撕裂,以及综合上升式和门修复用于广泛的剖析.
- 高风险标准包括虚弱,不输血,严重的COPD,冷的胸部,转移性癌症,低射出分数和肝硬化.
主要成果:
- 患者的平均年龄为76.3岁. 手术死亡率为10.3%,中风率为10.3%.
- 血管内修复包括上升式支架放置 (65.5%),Endo-Bentall (6.9%),Endo-Bentall加弧 (6.9%) 和上升式/弧形修复 (20.7%).
- 随访时间中位数为6.25个月. 总体内泄漏率为42.3%,对于离阴管结2厘米以内的破裂,明显高 (80%). 三名患者需要重新干预. 五年生存概率为35%.
结论:
- 复杂的EVAR用于高风险患者的上升大动脉剖析提供了有希望的早期结果,可控的死亡率和中风率.
- 内脏泄漏的高发病率,特别是大动脉根部附近的撕裂,是一个重大问题,导致长期生存率低下.
- 需要进一步的研究来完善技术,并改善复杂的 aTAAD 病例中 EVAR 的长期耐用性.
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