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一个系统的审查和对远端大动脉干预残留大动脉剖析的结果的元分析
Francesco Squizzato1, Marco James Bilato1, Mirko Menegolo1
1Vascular and Endovascular Surgery Division, Padua University, Padua, Italy.
Annals of vascular surgery
|October 17, 2025
概括
内血管修复 (ER) 与开放式手术修复 (OSR) 相比,在A型大动脉剖析 (TAAD) 修复后的残留剖析的死亡率较低. 然而,ER具有更高的再干预率,而这两种方法都显示出低的风险.
科学领域:
- 心血管外科心血管外科
- 血管外科 血管外科
- 大动脉疾病管理管理
背景情况:
- 甲型大动脉剖析 (TAAD) 修复可能会导致残留远端剖析.
- 这些残留剖析的管理需要仔细考虑治疗选择.
研究的目的:
- 为了比较内血管修复 (ER) 与TAAD修复后残留剖析的开放外科修复 (OSR) 的结果.
- 为了评估外科手术期间的死亡率,中风,脊髓缺血和重新干预率.
主要方法:
- 20项回顾性研究的系统综述和元分析.
- 包括1097名接受ER或OSR治疗的患者,用于远端残留剖析.
- 围绕手术死亡率,中风,脊髓缺血 (SCI) 和重新干预的综合分析.
主要成果:
- 远端再干预的总死亡率为6%;中风率为3%;SCI率为0%.
- 与OSR相比,ER显示下降性大动脉治疗的死亡率较低 (1%vs. 6%),但未来重新干预的风险较高 (10%vs. 2%).
- 在随访期间,大动脉相关的再干预率为13%.
结论:
- 在TAAD幸存者中,远端大动脉重新手术具有显著的死亡率和中风风险.
- 与OSR相比,ER提供了降低的死亡率,但增加了再干预率.
- 无论是ER还是OSR都可以在低风险的情况下进行;进一步的比较研究是有必要的.
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