以表格形式回顾了当代用于治疗胸腹主动脉瘤的栅栏式分支血管内主动脉修补术的经验。

Fernanda Jobim, Lucas Ruiter Kanamori, Martina Cambiaghi, Thomas Mesnard, Titia A Sulzer, Safa Savadi, Dora Babocs, Bruno Pagnin Schmid, Steven Maximus, Ying Huang, Fabio Verzini, Gustavo S Oderich
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引用次数: 0

摘要

导言:无论采用哪种技术,胸腹主动脉瘤(TAAAs)的修复都是一项技术挑战。开放式手术修复(OSR)是经过时间考验的选择,必须与新技术进行比较,它仍然被认为是年轻、体格健壮的遗传性主动脉疾病患者的金标准选择。对于解剖结构合适的患者,血管内修复是一种创伤较小的选择。本文旨在以表格形式回顾当代已发表的关于使用栅栏式分支技术进行TAAA血管内修复的数据:证据获取:使用 MEDLINE 和 Embase 数据库检索已发表的文献,包括评估 FB-EVAR 治疗 TAAAs 效果的单中心和多中心研究。纳入的研究发表于2010年1月1日至2024年7月11日之间,以英语撰写,提供了超过50例TAAA的FB-EVAR数据:修复时患者的平均年龄为 71 岁,男性占多数(65.5%)。大多数患者为克劳福德II度TAAA(21.6%),其次为III度(21.2%)。整个组群的早期死亡率为4.9%。最常见的不良事件是急性肾损伤(9.4%),其次是脊髓损伤(8.0%):结论:TAAA的FB-EVAR仍在不断发展。结论:TAAA的FB-EVAR手术仍在不断发展,与开放式TAAA修复术的历史结果相比,该表中对早期死亡率和发病率的汇总分析结果较低。
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Tabular review of contemporary fenestrated-branched endovascular aortic repair experiences for treatment of thoracoabdominal aortic aneurysms.

Introduction: Repair of thoracoabdominal aortic aneurysms (TAAAs) represents a technical challenge regardless of which technique is used. Open surgical repair (OSR) is the time-tested option against which novel techniques must be compared and it is still considered the gold standard option for younger, fit patients with heritable aortic diseases. Endovascular repair offers a less-invasive alternative in patients with suitable anatomy. This article aims to present a tabular review of the contemporary published data on endovascular repair of TAAAs using fenestrated-branched techniques.

Evidence acquisition: The published literature for single-center and multicenter studies evaluating the outcomes of FB-EVAR for TAAAs was searched using MEDLINE and Embase databases. Studies published between January 1st 2010 and July 11th 2024, in the English language which provided data on FB-EVAR of TAAAs with more than fifty reported cases were included.

Evidence synthesis: The average patient age at time of repair was 71 years old with majority of males (65.5%). Most patients presented with a Crawford Extent II TAAAs (21.6%), followed by Extent III (21.2%). Early mortality was 4.9% for the entire cohort. The most prevalent adverse event was acute kidney injury (9.4%), followed by spinal cord injury (8.0%).

Conclusions: FB-EVAR of TAAAs continues to evolve. Pooled analysis of early mortality and morbidity is lower in this tabular review than historical outcomes of open TAAA repair.

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