急性无并发症B型主动脉夹层行胸腔血管内主动脉修复术的人群风险分析。

Mohammed Al-Tawil, Alexander Geragotellis, Matti Jubouri, Sven Zcp Tan, Idhrees Mohammed, Ian Williams, Mohamad Bashir
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引用次数: 3

摘要

背景:非复杂性B型主动脉夹层(unTBAD)占B型主动脉夹层(TBAD)的大多数,没有任何与复杂性TBAD (coTBAD)相关的并发症。尽管coTBAD的一线治疗是胸椎血管内主动脉修复(TEVAR),尽管TEVAR已经证明其治疗unTBAD的安全性和有效性,但unTBAD仍主要采用保守治疗,只有一小部分患者接受TEVAR治疗。目的:本综述的主要范围是强调文献中关于接受TEVAR治疗的非tbad患者的人口统计学特征和相关合并症的证据,以便建立一个风险分层系统,以获得有利的结果。方法:利用PubMed、Ovid、Scopus、EMBASE等电子数据库进行综合文献检索。结果:确定、评估和调查了影响TEVAR结果的非tbad患者的多种人口统计学特征和相关合并症,包括年龄、性别、种族、遗传、医疗条件(如高血压和糖尿病)以及生活方式因素(如吸烟)。大多数因素与死亡率和发病率的增加有关,而其他因素,如种族,被认为对TEVAR有保护作用。结论:尽管TEVAR在unTBAD中取得了良好的结果,但其管理仍存在灰色地带。因此,在评估TEVAR干预的适应症时,将非tbad患者的人口统计学和合并症纳入临床判断,以确保获得最佳结果是很重要的。
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Population risk profile analysis of acute uncomplicated type B aortic dissection patients undergoing thoracic endovascular aortic repair.

Background: Uncomplicated type B aortic dissection (unTBAD) comprises the estimated majority of type B aortic dissection (TBAD), presenting without any of the complications associated with complicated TBAD (coTBAD). Although first-line treatment for coTBAD is thoracic endovascular aortic repair (TEVAR), and despite the fact that TEVAR has proven its safety and effectiveness in the treatment of unTBAD, unTBAD is still being predominantly managed conservatively with medical therapy, with a small proportion of patients being offered TEVAR.

Aims: The main scope of this review is to highlight the evidence in the literature of the demographic characteristics and associated co-morbidities of unTBAD patients undergoing TEVAR in order to produce a risk stratification system to achieve favourable outcomes.

Methods: A comprehensive literature search was conducted using multiple electronic databases including PubMed, Ovid, Scopus, and EMBASE.

Results: Multiple demographic characteristics and associated co-morbidities of unTBAD patients affecting TEVAR outcomes were identified, assessed, and investigated, including age, gender, race, genetics, medical conditions, such as hypertension and diabetes, and lifestyle factors such as smoking. Most factors were associated with increased risks of mortality and morbidity, while others, such as race, were identified as being protective against those when it comes to TEVAR.

Conclusion: Despite the favourable results yielded by TEVAR in unTBAD, there remains a grey area concerning its management. Thus, it is important to incorporate the demographics and co-morbidities of unTBAD patients' when into clinical judgement when assessing indications for TEVAR intervention to ensure optimum results can be achieved.

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来源期刊
CiteScore
1.30
自引率
0.00%
发文量
78
期刊介绍: The Asian Cardiovascular and Thoracic Annals is an international peer-reviewed journal pertaining to cardiovascular and thoracic medicine. Besides original clinical manuscripts, we welcome research reports, product reviews, reports of new techniques, and findings of special significance to Asia and the Pacific Rim. Case studies that have significant novel original observations, are instructive, include adequate methodological details and provide conclusions. Workshop proceedings, meetings and book reviews, letters to the editor, and meeting announcements are encouraged along with relevant articles from authors.
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