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在动脉支架中使用栓塞保护装置的周围程序结果

Santiago Callegari¹, Gaëlle Romain², Odaly S Balasquide Odeh³

¹Vascular Medicine Outcomes Program, Department of Internal Medicine, Section of Cardiovascular Medicine, Yale University, New Haven, CT; Department of Internal Medicine, Yale School of Medicine, New Haven, CT.

Journal of vascular surgery

|October 12, 2025

概括

没有栓塞保护装置 (EPD) 的动脉支架 (CAS) 与住院和30天死亡率的增加有关. 现实世界的数据表明,在CAS中使用EPD可能会改善患者的生存结果.

科学领域:

心血管干预心血管干预
血管外科血管外科
医疗器械技术医疗器械技术

背景情况:

动脉支架 (CAS) 是管理动脉狭窄的常见程序.
血栓保护装置 (EPD) 在降低CAS期间死亡率方面的有效性一直受到争议.
本研究探讨了EPD使用与CAS中的周围程序结果之间的关联.

研究的目的:

评估带有或没有栓塞保护装置 (EPD) 的动脉支架 (CAS) 之间的关联.
评估EPD使用对外围手术中风和死亡率的影响.
提供现实世界的证据,以提高CAS实践的质量.

主要方法:

从血管质量倡议注册 (2015-2019) 进行CAS的患者的分析.
排除跨动脉复血管化手术的可能性.
倾向性得分匹配 (1:1) 来比较成功使用EPD的CAS与没有EPD或失败的EPD尝试之间的结果.
对住院和30天死亡率以及中风/TIA结果的后勤回归和生存分析 (Kaplan-Meier,Cox比例危险).

主要成果:

总共分析了19451名患者,每组2062名患者在倾向分数匹配后进行了分析.
没有EPD的CAS与住院死亡率的几率显著增加有关 (OR,2.40).
两组之间没有观察到中风/过渡性缺血性发作率的显著差异 (OR,1.26).
没有EPD的患者与EPD患者相比,30天死亡风险翻了一番 (4.3%对2.0%).

结论:

在动脉支架 (CAS) 期间不使用栓塞保护装置 (EPD) 与住院和30天死亡率的增加有关.
现实世界的证据支持EPD使用在改善CAS结果的潜在好处.
这些发现建议考虑使用EPD作为CAS程序的质量指标.

关键词:

Carotid 动脉疾病动脉疾病冠状动脉支架的建立.栓塞保护装置的使用方法

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