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在TEVAR后偏离大动脉扩张的风险因素分析:系统性审查和元分析
Dongsheng Cui1,2, Xiang Li1,2, Yonghui Chen2,3
1Department of Vascular Surgery, Tianjin Medical University General Hospital, Tianjin, China.
概括
在胸内血管大动脉修复 (TEVAR) 后,远端大动脉扩张 (DAE) 影响了27%的患者. 男性,心肌梗塞和外周血管疾病增加了DAE的风险,而血栓形成是保护性的.
科学领域:
- 血管外科 血管外科
- 干预心脏病学 干预心脏病学
- 大动脉疾病管理管理
背景情况:
- 远端大动脉扩张 (DAE) 是胸内血管大动脉修复 (TEVAR) 后长期结果的关键决定因素.
- 识别DAE的风险因素对于改善患者管理和减少晚期并发症至关重要.
研究的目的:
- 系统地识别和量化与TEVAR后手术后远端大动脉扩张 (DAE) 相关的风险因素.
- 通过元回归分析探索DAE的预测因素.
主要方法:
- 来自PubMed,Embase和Cochrane图书馆数据库的研究的系统审查和元分析.
- 使用随机效应模型计算的聚合效应估计;用Cochran的Q和I2统计数据评估异质性.
- 用于探索预测因素和出版偏差的元回归和埃格尔测试.
主要成果:
- 包括24项研究,报告DAE总发病率为27% (95%CI:21%-35%).
- DAE的危险因素包括男性性别,心肌梗塞,外周血管疾病,perfusion和术后虚假光线扩张.
- 预防DAE的保护因素包括年龄较大,之前的心脏手术,充血性心力衰竭,残留剖析和远端虚假光线血栓.
结论:
- 在TEVAR后的DAE受患者的并发症和大动脉重塑特征的影响.
- 高风险个人资料 (男性性别,心血管并发症,持续的虚假光线) 可以指导优化监测策略.
- 这些发现支持风险调整的监测,并突出了虚假光线血栓对于TEVAR长期耐用性的重要性.
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