独特的支架移植修改在紧急情况下高风险的患者对大动脉门病理
Michał Żołnierczuk1, Paweł Rynio1, Anita Rybicka2
1Department of Vascular Surgery, General Surgery and Angiology, Pomeranian Medical University, Szczecin, Poland.
概括
医生修改的支架移植 (PMSG) 为高风险患者的急需大动脉门修复提供了一个可行的解决方案. 这种技术证明了100%的技术成功和良好的中期生存率,在没有标准选项的情况下提供了至关重要的替代方案.
科学领域:
- 血管外科 血管外科
- 血管内干预 血管内干预
- 大动脉疾病管理管理
背景情况:
- 大动脉门病理存在复杂的内血管治疗挑战.
- 定制设备和混合程序在可用性和侵入性方面存在限制.
- 医生修改的支架移植 (PMSG) 正被探索为紧急干预的替代方案.
研究的目的:
- 评估一种新的PMSG技术对急性大动脉综合征的安全性和有效性.
- 评估高风险患者的结果,需要紧急的大动脉门干预.
- 为了确定使用患者特定的3D打印模板进行支架移植修改的可行性.
主要方法:
- 一个单一中心研究18名患有急性大动脉综合征的高风险患者.
- 经过修改的Medtronic Valiant支架移植,使用无菌的3D打印模板进行窗体化.
- 评估技术成功,早期和中期结果,神经复杂症,内脏泄漏和生存.
主要成果:
- 100%的技术成功,没有30天死亡率.
- 四次非致残性中风,一次进入部位出血修复,一次过渡性脊髓缺血.
- 83%的中期存活率 (中位数为43个月),有5个内脏泄漏;没有移植感染或迁移.
结论:
- 在高风险患者中,PMSGs是紧急大动脉门修复的可行和有效选择.
- 当标准设备不可用时,该技术允许量身定制的解决方案,显示出高度的技术成功.
- 需要进一步的多中心研究来证实长期的安全性,并完善紧急大动脉治疗方案的技术.
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