在Evar中优化关节接入:选择性和紧急设置中的皮肤外科和外科手术方法的多中心比较
Chiara Barillà1, Giulia Colonna2, Filippo Benedetto1
1Unit of Vascular Surgery, Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Policlinico G Martino, University of Messina, Messina, Italy.
Annals of vascular surgery
|January 8, 2026
概括
通过皮肤的股骨接入用于内血管动脉瘤修复 (EVAR) 显示出比手术切割更好的短期结果. 诸如年龄和囊大小等因素会影响治疗方法的选择,强调个性化的患者护理.
科学领域:
- 血管外科 血管外科
- 干预心脏病学 干预心脏病学
- 医疗器械技术 医疗器械技术
背景情况:
- 内血管动脉瘤修复 (EVAR) 是对腹膜下腹动脉瘤 (AAA) 的开放修复 (OR) 的首选替代方案.
- 进入大腿动脉对于EVAR手术至关重要.
- 皮肤穿和手术的股骨接入之间的选择会影响患者的治疗结果.
研究的目的:
- 在选择性和紧急/紧急EVAR中,比较皮肤穿透大腿接与外科切割的结果.
- 识别影响大腿部接入技术选择的因素.
主要方法:
- 来自两个学术中心的711个EVAR程序和1422个大腿部接入点 (2015-2023) 的回顾性分析.
- 主要结局包括技术成功,访问站点并发症和重大不良事件 (MAE).
- 二次结局:重症监护室和住院,输血率,伤口感染和影响因素.
主要成果:
- 皮肤通道接入 (44.7%) 与显著降低的出血率 (p<.001),住院死亡率 (p<.001),更短的住院时间 (p<.001) 和减少ICU需求 (p<.001) 相关.
- 年龄,体重指数和大大小 (>16 Fr) 是影响接入选择的重要因素.
- 这些好处在选择性和紧急/紧急环境中都被观察到.
结论:
- 穿皮腿部接入显示出优越的短期结果,与手术切割相比,为EVAR.
- 操作人员的专业知识和患者特定的解剖学因素对于成功的穿皮技术至关重要.
- 选择接入方法应根据患者的特征和临床环境进行个性化.
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