在TEVAR与EVAR中的光镜时间和辐射暴露:系统性审查和元分析
Fotios O Efthymiou1, Christos F Pitros2, Constantine N Antonopoulos2
1Department of Medical Physics, School of Medicine, University of Patras, 26504 Patras, Greece.
Annals of vascular surgery
|January 15, 2026
概括
这项研究发现,胸内血管动脉瘤修复 (TEVAR) 使用的光镜时间 (FT) 比内血管动脉瘤修复 (EVAR) 少. 然而,像KERMA区域产品 (KAP) 这样的辐射剂量是相似的,突出了内血管手术中复杂的辐射暴露因素.
科学领域:
- 医疗成像医学成像
- 干预心脏病学 干预心脏病学
- 辐射瘤学 辐射瘤学
背景情况:
- 电离辐射是内血管外科手术中已知的风险.
- 患者的辐射暴露在不同的内血管程序之间有很大的差异.
研究的目的:
- 系统地审查和元分析患者在内血管动脉瘤修复 (EVAR) 和胸部 EVAR (TEVAR) 期间的辐射暴露.
- 为了比较EVAR和TEVAR之间的光镜时间 (FT),克尔玛面积积积 (KAP) 和累积空气克尔玛 (CAK).
主要方法:
- 从2015年6月到2025年6月,在主要数据库 (MEDLINE,Scopus,Cochrane图书馆) 进行了符合PRISMA的文献搜索.
- 包括78项研究 (73项EVAR,5项TEVAR) 包含≥20名患者,报告FT,KAP或CAK.
- 随机效应建模用于聚合分析,评估了偏差风险和出版偏差.
主要成果:
- 与EVAR (28.50分钟) (p<0.001) 相比,TEVAR的FT时间显著更短 (15.25分钟).
- 在KAP (151.08与147.46 Gycm2;p=0.970) 或CAK (804.92与1091.03 mGy;p=0.090) 中没有发现显著差异.
- 观察到很高的异质性 (I2>85%);只有11.5%的研究报告了ALARA合规性,并很少使用融合成像 (9%).
结论:
- 在EVAR和TEVAR期间的辐射暴露是可变的,受解剖学,技术和实践的影响.
- 虽然TEVAR具有较短的FT,但其KAP值与EVAR相当或高于EVAR,可能是由于胸部成像几何学.
- 对TEVAR的有限数据限制了最终的比较结论.
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