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传染性大动脉动脉瘤的管理:短期和中期结果
Simon Frisch1, Nicla Settembre2, Rabie Ali Belkorissat1
1Department of Vascular and Endovascular Surgery, Nancy University Hospital, University of Lorraine, Nancy, France.
Annals of vascular surgery
|March 7, 2025
概括
结合抗生素的激进开放手术对传染性大动脉动脉瘤 (IAA) 有效. 血管内治疗提供了可接受的结果,而医疗管理只适用于高死亡风险的不可手术的患者.
科学领域:
- 心血管外科心血管外科
- 传染性疾病 传染性疾病
- 血管外科 血管外科
背景情况:
- 传染性大动脉动脉瘤 (IAA) 是一种罕见的,迅速发展的,危及生命的血管疾病.
- 管理需要一个多学科的方法.
- 对IAA患者来说,评估治疗结果和死亡因素至关重要.
研究的目的:
- 通过使用各种治疗策略,评估因感染性大动脉动脉瘤 (IAA) 接受治疗的患者的死亡率.
- 在IAA管理中调查传染性复发率并确定影响死亡率的因素.
主要方法:
- 一项回顾性研究包括47名在2009年9月至2023年10月期间确诊IAA的患者.
- 治疗包括激进的开放性手术与生物重建,内血管修复或医疗管理.
- 收集的数据包括临床,生物,微生物学,放射学和核医学发现,随访30天,1年和3年.
主要成果:
- 整体30天,1年和3年生存率分别为78.7%,52.4%和44.4%.
- 激进的开放性手术显示了较高的存活率 (60.6%在3年) 与内血管治疗 (20.8%在3年).
- 仅仅通过医疗治疗,对于持久性感染,3年后的生存率为0%.
结论:
- 将医疗治疗与激进的开放手术相结合,是治疗传染性大动脉动脉瘤的有效策略.
- 内血管治疗为IAA提供了可接受的结果.
- 由于高死亡风险,医疗管理应保留给不可手术的患者.
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