在症状性动脉狭窄症中进行动脉外血管化:系统性审查
Francisco Garcia1, Filipa Jácome1,2, Joel Sousa3,2
1Faculty of Medicine of the University of Porto, Porto, Portugal.
概括
横动脉复血管化 (TCAR) 显示出对症状性动脉狭窄的有希望的安全性. 这种微创手术可能适用于高风险患者,但需要进一步进行比较研究.
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:
- 冠状动脉内关节切除术是症状性冠状动脉狭窄症的标准.
- 动脉支架是一种替代方案,但结果不佳.
- 横动脉复血管化 (TCAR) 是一种新兴的治疗方法,具有有前途的结果.
研究的目的:
- 系统地审查有关TCAR安全性的现有证据.
- 为了评估TCAR在治疗症状性动脉狭窄症的疗效.
主要方法:
- 按照PRISMA指南进行了一次系统的文献审查.
- 在PubMed和Web of Science进行了搜索,得到了178项研究.
- 11项涉及28326名患者的研究被选中进行分析.
主要成果:
- 住院TIA/中风的发病率在2.3-3.3%之间,30天发病率在1.2-4.3%之间.
- 住院死亡率为0.5-0.7%,在30天后增加到1-4.9%.
- 并发症的发生率包括心血管事件 (高达2.9%),神经损伤 (高达0.7%) 和接入并发症 (1.2-6.1%).
结论:
- TCAR在症状性动脉狭窄症中显示出有前途的安全性和有效性.
- 它提供了一种可行的 carotid endarterectomy 替代方案,特别是在高危人群中.
- 需要进一步的研究来比较TCAR直接与动脉内关节切除术.
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