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一项研究将EVAR后破裂动脉瘤的结果与未经先前治疗发生的动脉瘤的结果进行比较
Konstantinos G Moulakakis1, Andreas M Lazaris1, Constantine N Antonopoulos1
1Hellenic Vascular Registry (HEVAR); 1(st) Department of Vascular Surgery, Attikon University Hospital, National and Kapodistrian University of Athens school of Medicine, Athens, Greece.
Annals of vascular surgery
|December 20, 2025
概括
腹腔大动脉动脉瘤 (AAA) 的内血管大动脉修复后破裂 (EVAR) 与新的破裂相比,呈现出类似的血液动力学不稳定性和高死亡率. 年龄,冲击和开放修复显著预测AAA破裂患者的死亡率.
科学领域:
- 血管外科 血管外科
- 大动脉动脉瘤研究研究
- 血管内干预 血管内干预
背景情况:
- 内血管大动脉修复 (EVAR) 越来越多地用于腹腔大动脉动脉瘤 (AAA),但破裂仍然是一个关键的并发症.
- 在接受治疗的患者中,EVAR后破裂发生在1-5%,构成重大威胁.
- 将破裂EVAR (reVAR) 与没有先前干预 (rWPT) 的结果进行比较,对于理解AAA破裂管理至关重要.
研究的目的:
- 为了比较患者特征,血液动力学状况,以及以前有EVAR和没有EVAR的破裂AAA患者之间的结果.
- 为了确定患有AAA破裂的患者死亡率的预后因素.
主要方法:
- 从HEVAR注册表 (2019年1月 - 2023年11月) 分析前性记录的数据.
- 包括连续患有破裂的内/内AAA,正在进行内血管或开放修复的患者.
- 两个组的比较:以前有EVAR (rEVAR) 的患者和以前没有大动脉干预 (rWPT) 的患者.
主要成果:
- 总共研究了203名AAA破裂患者;19.7%的人以前有EVAR.
- 在rEVAR和rWPT组之间呈现时血液动力学状况没有显著差异.
- 总死亡率为40.4%;rEVAR死亡率 (37.5%) 与rWPT (41.1%) 并没有显著差异.
- 年龄,血液动力学休克和开放性修复是死亡率的重要预测因素.
结论:
- 在EVAR后的AAA破裂患者表现出类似的血液动力学不稳定性,就像新的破裂患者一样.
- 在EVAR后破裂AAA的死亡率很高,与新的破裂相美.
- 年龄,最初的血液动力学冲击和接受开放性修复是AAA破裂死亡率的关键风险因素.
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