在下内动脉疾病的内血管干预失败后,目标流出血管的妥协
Mohammed Elkassaby1, Surbhi Chawla2, Mary-Paula Colgan2
1Department of Vascular Surgery, St. James's Hospital, Dublin, Ireland; Department of Vascular Surgery, University Hospital Waterford, Ireland; Department of vascular surgery, Mansoura University, Egypt.
概括
一个内血管第一策略是安全的下内动脉疾病. 失败的血管增生术很少损害外流血管,从而保留了对周围动脉疾病 (PAD) 的未来治疗选择.
科学领域:
- 血管外科 血管外科
- 干预心脏病学 干预心脏病学
- 周围动脉疾病管理管理
背景情况:
- 对于下 inguinal 动脉疾病的最佳策略仍在争论中,人们担心因失败的内血管程序而导致的外流血管损伤.
- 现有的研究,包括BEST CLI和BASIL II试验,尚未最终解决绕道-首先与内血管-首先的争论.
研究的目的:
- 在患有下 inguinal 动脉疾病的患者中,在血管移植术失败后,评估目标流出血管损伤的程度.
- 通过检查血管移植术失败后的结果,评估内血管第一方法的安全性和有效性.
主要方法:
- 在5年内对724次下血管形成术进行了回顾性分析,重点是101次失败发作.
- 主要终点:目标流出容器损伤的存在和程度.
- 二级终点:并发症,死亡率,再干预类型和成功率.
主要成果:
- 在78.2%的失败血管增生术中,没有观察到目标输出血管受损.
- 在42%的病例中,再造血管造形术成功 (p=0.069).
- 开放式外科绕道 (OSB) 在随后的干预中实现了91%的成功率 (p=0.009).
结论:
- 内血管第一策略对于治疗外围动脉疾病 (PAD) 是安全有效的.
- 在血管造形术失败后,人们对未来治疗选择受到损害的担忧,这项研究并未证实.
- 这些数据支持了内血管方法的可行性,而不会危及随后的手术干预.
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