术前功能受限与30D死亡率和心力衰竭的恶化有关,在 Carotid 动脉支架后
Daniel Willie-Permor1, Munir Paul Moacdieh1, Shatha Herz Allah1
1Center for Learning and Excellence in Vascular & Endovascular Research(CLEVER), Division of Vascular and Endovascular Surgery, Department of Surgery, University of California, San Diego (UCSD), La Jolla, California.
The Journal of surgical research
|October 20, 2025
概括
术前功能有限显著增加了30天死亡率和充血性心力衰竭 (CHF) 风险在动脉支架 (CAS) 后. 然而,中风和心肌梗塞的风险仍然相似,这表明非流动患者的量身定制管理.
科学领域:
- 血管外科 血管外科
- 干预心脏病学 干预心脏病学
- 健康 结果 研究 研究 结果
背景情况:
- 动脉支架 (CAS) 是高风险患者显著动脉狭窄的关键干预措施.
- 手术前的门诊状态是评估动脉复血管化风险的关键因素,但其对CAS结果的影响尚未完全理解.
研究的目的:
- 通过使用血管质量倡议 (VQI) 数据库,根据手术前的门诊状态分层评估CAS的早期结果.
- 为了确定有限的术前功能和CAS后的不良结果之间的关联.
主要方法:
- 在VQI数据库中分析2016-2021年非新出现的CAS案例.
- 患者的分层是完全功能和有限功能 (LF) 组.
- 倾向性得分匹配和后勤回归用于比较30天死亡率和术后并发症.
主要成果:
- 功能受限 (LF) 患者 (3.54%) 年龄较大,并患有更多的并发病,包括糖尿病,高血压,慢性肺炎,慢性心血管疾病和透析依赖.
- 在倾向匹配后,LF患者的30天死亡率 (OR:2.59) 和术后CHF (OR:2.03) 的几率明显更高.
- 两组之间中风,TIA,MI或任何术后并发症的几率没有显著差异.
结论:
- 术前功能状况有限是CAS后30天死亡率和术后CHF增加的重要预测因素.
- 关于中风,TIA和MI的CAS结果在功能组之间没有显著差异.
- 建议在非行走患者中对无症状的动脉狭窄症进行积极的医疗管理,并在有症状的个体中进行手术前优化.
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