立动脉动脉瘤的当代管理:综合性审查
Giulia Bertagna1, Valentina Scarati1, Nicola Troisi1
1Vascular Surgery Unit, Department of Translational Research and of New Technologies in Medicine and Surgery, University of Pisa, Cisanello Hospital, Via Roma 67, 56126 Pisa, Italy.
Medicina (Kaunas, Lithuania)
|November 27, 2025
概括
开放式手术修复 (OPAR) 对无症状的多动脉动脉瘤 (PAA) 显示出比内血管修复 (EPAR) 更好的长期结果. OPAR提供卓越的初级通透性和免于重新干预,使其成为当前的护理标准.
科学领域:
- 血管外科 血管外科
- 干预心脏病学 干预心脏病学
- 医疗技术评估 医疗技术评估
背景情况:
- 目前的指导方针建议对无症状的多动脉动脉瘤 (PAA) >20毫米进行干预.
- 开放式外科修复 (OPAR) 和内血管修复 (EPAR) 是主要的治疗选择.
- 需要对长期结果进行明确的比较.
研究的目的:
- 为了比较OPAR和EPAR对无症状PAA的结果.
- 为PAA提供当前管理策略的概述.
- 评估两种维修技术的早期,中期和长期结果.
主要方法:
- 在遵守PRISMA指南的基础上进行系统审查.
- 在MEDLINE,Pubmed,Scopus和Web of Science (2010年1月至2025年7月) 上进行的搜索.
- 分析技术成功,死亡率,MACE,通病率和重新干预率.
主要成果:
- 分析了21篇文章,涉及9760名患者和10,062个肢体.
- 无论是OPAR还是EPAR,都显示出高的技术成功率 (高达100%).
- 与EPAR相比,OPAR显示出明显更好的初级通透率 (79.8%与63.8%) 和不需要重新干预 (82.2%与68.4%).
结论:
- 内血管修复是可选PAA的安全有效选择,但长期数据有限.
- 开放式外科修复仍然是首选的方法,因为它具有优越的长期透视率.
- 需要进一步进行大规模的长期研究,以充分阐明EPAR的好处.
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