由于外周动脉疾病而进行动脉切除术
Siddhant Pherwani1, Ahmed Gendia2, Shampa Sen3
1Renal Transplant Surgery, Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, UK.
The Cochrane database of systematic reviews
|January 6, 2026
概括
目前关于为外周动脉疾病 (PAD) 进行除术的证据尚不确定. 这次审查发现,与气球血管整形相比,结果没有显著差异,但需要更多的研究.
科学领域:
- 血管外科 血管外科
- 干预心脏病学 干预心脏病学
- 基于证据的医学基于证据的医学.
背景情况:
- 周围动脉疾病 (PAD) 是一种常见的疾病,由下肢动脉狭窄引起.
- 动脉切除术是一种内血管技术,用于去除动脉斑块,但与传统治疗相比,其有效性尚不清楚.
- 对于PAD的atherctomy的使用正在增加,需要清楚地了解其益处和危害.
研究的目的:
- 评估切除术的益处和危害与外围动脉疾病的其他治疗方法相比.
- 本综述是Cochrane综述的更新,重点是随机对照试验.
主要方法:
- 在多个数据库 (CENTRAL,MEDLINE,Embase,CINAHL,AMED) 和临床试验注册表中进行了搜索.
- 包括随机对照试验,比较症状PAD患者的atherctomy与其他已确定的治疗方法.
- 使用Cochrane RoB 1工具评估偏差风险,并使用元分析合成结果,结果包括初级通病率,死亡率,心血管事件,再血管化和并发症.
主要成果:
- 纳入了11项研究,814名参与者,比较了切除术与气球血管整形 (BA) 或BA与支架.
- 在初级通透性,死亡率,心血管事件,目标血管再血管化或切术和BA之间的并发症率之间没有发现显著差异.
- 对atherctomy与stenting的证据是有限的,结果没有明显的差异,但由于偏差和不准确性的高风险,所有比较的证据确定性非常低.
结论:
- 目前关于PADatherctomy的证据仍然高度不确定.
- 与气球血管整形或支架相比,没有明确的益处或危害证据.
- 需要进行更大,更高质量的研究,以确定在PAD治疗中切除术的疗效和安全性.
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