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内血管时代下降胸前动脉的开放性手术:一个单一的中心体验

Nesar A Hasami¹, Michelle Smulders¹, Michel W A Verkroost¹

¹Department of Cardiothoracic Surgery, Radboud University Medical Centre, Nijmegen, The Netherlands.

European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery

|December 14, 2025

概括

开放式下降胸前动脉 (DTA) 修复是不适合内血管修复的患者的可行选择. 经验丰富的中心实现了较低的死亡率和并发症率,支持其在DTA治疗中继续考虑.

科学领域:

心血管外科心血管外科
胸部外科手术胸部外科手术
大动脉疾病管理管理

背景情况:

胸内血管大动脉修复 (TEVAR) 是下降胸大动脉 (DTA) 病理的标准.
一部分患者不符合TEVAR的条件,需要进行开放式手术修复.
这项研究评估了在一个大量的第三级推中心开放的DTA修复的结果.

研究的目的:

报告下降胸前动脉 (DTA) 病理的开放性手术修复的结果.
评估接受开放式DTA修复的患者的死亡率和重大不良事件率.
确定开放式DTA修复在当代大动脉疾病管理中的作用.

主要方法:

在2013年至2024年间接受开放式DTA修复的患者的回顾性分析.
对基线特征,手术细节和术后结果的审查.
主要结局:手术死亡率;次要结局:中风,脊髓缺血,气管切除术,透析.

主要成果:

95名患者接受了孤立的开放式DTA修复 (71名可选);常见的适应症包括剖析后动脉瘤和胸.
三十天和手术死亡率为3%;90天死亡率为6%.
主要并发症包括中风 (1%) 和脊髓缺血 (2%);1年和5年生存率分别为94.7%和91.6%.

结论:

开放式DTA修复仍然是患者无法接受内血管修复的必要选择.
在经验丰富的中心,开放的DTA修复表明死亡率和并发症率较低.
开放的DTA修复应该被认为是DTA病理的治疗武器库中宝贵的一部分.

关键词:

动脉瘤是一个动脉瘤.大动脉的大动脉.下降的胸腔大动脉下降剖析剖析分解外科手术医疗外科手术胸内血管大动脉修复

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