目前对胸前动脉动脉瘤的管理实践与女性症状呈现增加有关
David J Jiang1, Joseph A Pugar1, Trissa A Babrowski1
1Section of Vascular Surgery and Endovascular Therapy, Department of Surgery, University of Chicago, Chicago, IL.
Journal of vascular surgery
|August 3, 2025
概括
胸前大动脉动脉瘤的女性患者更有可能出现破裂或症状. 经身体表面积调整的大动脉大小指数,在女性中更大,预测不良事件,但干预标准没有改变.
科学领域:
- 心血管外科心血管外科
- 血管外科 血管外科
- 大动脉动脉瘤研究研究
背景情况:
- 建立了大动脉动脉瘤自然史和结果的性别特异性差异.
- 胸内血管动脉瘤修复 (TEVAR) 是对下降胸大动脉动脉瘤 (DTAA) 的关键治疗方法.
研究的目的:
- 评估TEVAR对DTAA的当代结果.
- 分析十年来管理模式的趋势,重点关注性别差异.
主要方法:
- 对DTAA接受TEVAR的患者进行血管质量倡议数据库 (2013-2023) 的分析.
- 一个有动脉瘤<55毫米的队列的二次分析.
- 主要结局:出现症状和/或破裂.
- 动脉瘤大小的分析,根据大动脉大小指数进行调整.
主要成果:
- 包括2383名患者 (1183名女性,1200名男性).
- 女性有更高的症状或破裂动脉瘤呈现率 (35.9%对29.1%).
- 身体表面积调整的大动脉大小指数 (ASI) 在女性中较大,并独立预测症状呈现或破裂.
结论:
- 接受TEVAR治疗DTAA的女性患者更频繁地出现症状性或破裂性动脉瘤.
- BSA调整后的ASI在女性中更大,并预测了不良表现.
- 干预时动脉瘤的中位数大小没有显著变化,这表明由于目前的标准,女性的风险仍然较高.
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