脏动脉支架与复杂的单侧脏病变的开放手术重建:一个随机试验
Shoraan Saaya1, Alexander Gostev1, Olesia Osipova1
1Department of Vascular and Hybrid Surgery, Meshalkin National Medical Research Center, Novosibirsk, Russian Federation.
Annals of vascular surgery
|September 18, 2025
概括
与开放式重建 (OR) 相比,内血管治疗 (ET) 提供了较短的住院时间和较少的并发症,用于复杂的阴病变. 然而,开放式重建显示在36个月后更高的长期初级通透率.
科学领域:
- 血管外科 血管外科
- 干预心脏病学 干预心脏病学
- 医疗技术 医疗技术 医学技术
背景情况:
- 复杂的单侧阴病变是一个重大的临床挑战.
- 对比内血管治疗 (ET) 和开放外科重建 (OR) 对于最佳的患者管理至关重要.
- 在这些干预中,常见的股骨动脉节约方法是关键.
研究的目的:
- 为了比较ET与OR的安全性和有效性,用于复杂的单侧阴病变.
- 评估初级和二级通透率以及并发症概况.
- 评估长期结果,包括主要不良肢体事件.
主要方法:
- 随机试验涉及202名患有TASC C/D腹腔病变的患者,从2015年8月到2020年11月.
- 患者被随机分配到ET (101) 或OR (101).
- 主要结局包括技术成功,30天的通透性和并发症;次要结局评估了36个月的通透性和四肢事件.
主要成果:
- 内血管治疗 (ET) 导致住院时间缩短,手术后30天并发症率显著降低 (3.96%对比15.84%).
- 在开放式重建 (OR) 后,36个月的初级通透率显著更高 (88.12%与75.25%相比).
- 36个月的二次通透率和无截肢生存率在ET和OR之间没有显著差异.
结论:
- 内血管治疗 (ET) 在减少住院时间和减少复杂阴病变的早期并发症方面表现出优势.
- 开放式手术重建 (OR) 在36个月实现了优异的初级通透率.
- 虽然ET提供了即时的好处,但长期的通透性考虑有利于某些患者群体的OR.
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