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在内血管大动脉修复后,对移植感染的二十年单一中心经验
Iikka Järvinen1, Ivika Heinola1, Ilkka Kantonen1
1Department of Vascular Surgery, University Hospital of Helsinki, Helsinki, Finland.
Annals of vascular surgery
|May 14, 2025
概括
内血管动脉瘤修复 (EVAR) 移植感染发生在1.7%的患者中. 用生物材料进行感染EVAR移植和重建提供了耐用,抗感染的解决方案,并提高了生存率.
科学领域:
- 血管外科 血管外科
- 传染病管理 传染病管理
- 在重建中的生物材料.
背景情况:
- 内血管动脉瘤修复 (EVAR) 是腹腔大动脉动脉瘤的常见手术.
- 在EVAR之后的移植感染是一种严重的并发症,需要有效的治疗策略.
- 20年来,只有一个机构使用了移植实验和现场生物重建.
研究的目的:
- 为了确定EVAR移植感染的发病率.
- 为了评估治疗EVAR移植感染的结果,使用探索和现场生物重建.
- 为了比较不同治疗方式之间的生存率和再感染率.
主要方法:
- 一个潜在的血管外科手术数据库 (2000-2022) 的回顾性分析.
- 对EVAR后感染的识别和审查.
- 结果的比较,包括死亡率,存活率,免于再感染和重新干预.
主要成果:
- 在1274名患者中观察到1.7%的累积EVAR移植感染率.
- 与保守治疗 (22.2%) 相比,移植扩张和现场生物重建 (n=22) 显示了3年生存率 (68.2%) 的改善.
- 在接受生物重建治疗的患者中,没有发生再感染或晚期移植重新干预.
结论:
- 在现场生物重建的EVAR移植扩张是EVAR感染的可行治疗方法.
- 这种方法提供了一种持久且抗感染的解决方案.
- 生物重建显著改善患者在EVAR感染后的生存率.
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