在日本人群中适合跨状体跨导管大动脉置换的适用性
Masaki Nakashima1, Natsuko Satomi1, Daishi Tazawa1
1Department of Cardiology, Sendai Kousei Hospital, Miyagi, Japan.
JACC. Asia
|March 4, 2026
概括
跨关节 (TC) 跨导管大动脉置换 (TAVR) 适合大多数日本患者,即使是那些具有具有挑战性的输膜 (TF) 接入的患者. 这项研究发现TC-TAVR的整体适用性很高,表明其作为可行的替代方法的潜力.
科学领域:
- 心血管医学 心血管医学
- 干预心脏病学 干预心脏病学
- 血管外科 血管外科
背景情况:
- 跨状 (TC) 跨导管大动脉置换 (TAVR) 在西方人群中显示出希望,但其在亚洲人口结构中的适用性尚未确立.
- 关于日本患者对TC-TAVR的解剖学适应性的数据有限,需要进一步调查.
研究的目的:
- 评估日本患者常见动脉 (CCA) 的解剖特征.
- 确定日本患者对TC-TAVR的适合性,特别是那些具有具有挑战性的输血道 (TF) 接入的患者.
主要方法:
- 一个单一中心的回顾性研究分析了336名接受TAVR的患者.
- 患者被分为强硬的TF (需要替代接入) 和可行的TF组.
- 根据CCA直径,化,斑块和逆侧狭窄的情况来评估TC-TAVR的适用性.
主要成果:
- 右侧的中枢动脉较左侧的中枢动脉大,但比左侧的中枢动脉更为曲折.
- 强硬的TF组与可行的TF组相比,经历了较高的主要血管并发症发生率.
- 总的来说,TC-TAVR适应性很高 (91.1%),但在强硬TF组 (86.3%) 和可行的TF组 (93.6%) 中较低. 周围动脉疾病是适合性的负面预测因素.
结论:
- 尽管在强硬TF组的适应性降低,但这些患者中的绝大多数 (86%) 仍然是TC-TAVR的候选人.
- 在日本人口中,TC-TAVR为TAVR提供了一个有前途的替代性接入路线,即使在难以通过腿部接入的情况下也是如此.
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