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乙型主动脉剖析的内血管修复伴随着逆行性室内血瘤
Xiaolang Jiang1,2, Lingwei Zou1,2, Hao Liu1,2
1Institute of Vascular Surgery, Department of Vascular Surgery, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China.
概括
胸内血管大动脉修复 (TEVAR) 对于B型大动脉剖析 (TBAD) 具有延伸到0.0区的逆行性室内血瘤 (RTIMH) 有效. 然而,涉及近端上升大动脉的RTIMH患者需要更密切的随访,因为再干预率更高.
科学领域:
- 心血管外科心血管外科
- 血管外科 血管外科
- 干预心脏病学 干预心脏病学
背景情况:
- 带有逆行性室内血瘤 (RTIMH) 的B型大动脉剖析 (TBAD) 提出了复杂的管理挑战.
- 延伸到近端大动脉 (区域0-2) 的RTIMH可能会影响治疗结果.
- 胸内血管大动脉修复 (TEVAR) 是对复杂的大动脉病理的不断发展的治疗方法.
研究的目的:
- 评估TEVAR在涉及0-2区的TBAD和RTIMH患者的治疗结果.
- 将涉及0区的RTIMH患者与局限于1和2区的RTIMH患者之间的结果进行比较.
- 确定TEVAR后与大动脉不良事件 (AAE) 相关的因素.
主要方法:
- 对155名接受TEVAR治疗TBAD和RTIMH的患者进行了回顾性多中心研究.
- 患者被分为两组:涉及0-2区的RTIMH (组1) 和仅涉及1-2区的RTIMH (组2).
- 主要终点是任何AAE,包括剖析进展,大动脉相关死亡率,重新干预和并发症.
主要成果:
- 整体AAE在各组之间没有显著差异 (总共9.0%).
- 第1组患者年轻,在内主动脉弧曲线处有更多的初级入口撕裂.
- 在第一组 (79.1%) 与第二组 (93.3%) 相比,无需重新干预的情况明显较低.
结论:
- TEVAR是选择的TBAD患者的可行的治疗方法,RTIMH延伸到0.0区.
- 在RTIMH向近端上升大动脉扩散的患者中,更高的再干预率需要谨慎监测.
- 密切跟踪对于TEVAR后涉及0区的RTIMH患者至关重要.
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