[无并发症的 B 型主动脉夹层患者早期接受胸腔内移植手术是安全的】。]

IF 0.5 4区 医学 Q4 SURGERY Zentralblatt fur Chirurgie Pub Date : 2024-10-01 Epub Date: 2023-05-30 DOI:10.1055/a-2060-9864
Thomas Betz, Karin Pfister, Wilma Schierling, Georgios Sachsamanis, Piotr Kasprzak, Kyriakos Oikonomou
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引用次数: 0

摘要

关于无并发症的 B 型主动脉夹层(TBAD)的治疗方案,有许多出版物。早期TEVAR(胸腔内血管主动脉修复术)可提高主动脉特异性存活率,长期延缓疾病进展。我们对 2017 年 2 月至 2021 年 9 月期间在我院接受治疗的所有 TBAD 患者进行了回顾性分析。我们对 2017 年 2 月至 2021 年 9 月期间我院收治的所有 TBAD 患者进行了回顾性分析,分析了合并症、术中数据、30 天死亡率和术后并发症。其中 6 名患者接受了最佳药物治疗(BMT)。55 名患者接受了 TEVAR 和 BMT 治疗。11例患者(20%)为复杂性TBAD,12例患者(22%)为无并发症且具有高风险特征的TBAD,32例患者(58%)为无并发症的TBAD。技术成功率为 100%。无并发症 TBAD 患者均在术后 30 天内死亡。一名无并发症的 TBAD 患者在 TEVAR 术后发生了中风。无并发症的TBAD患者可通过早期TEVAR治疗,围手术期并发症发生率较低。对于无并发症的TEVAR和高危患者,应考虑选择早期TEVAR加BMT治疗。
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[Early Thoracic Endografting is Safe in Patients with Uncomplicated Type B Aortic Dissection].

There are many publications dealing with treatment options for uncomplicated type B aortic dissection (TBAD). Early TEVAR (Thoracic Endovascular Aortic Repair) may improve aortic-specific survival and delay disease progression in the long-term. Especially in patients with uncomplicated TBAD and additional high-risk features, preemptive TEVAR may improve late outcomes.We conducted a retrospective analysis of all patients treated for TBAD in our hospital between February 2017 and September 2021. Comorbidities, intraoperative data, 30-day mortality and postprocedural complications were analysed.During the above-mentioned period, 61 patients (38 males, median age 63 years) with TBAD were treated. Six patients received best medical treatment (BMT). 55 patients were treated by TEVAR and BMT. 11 patients (20%) had complicated TBAD, 12 patients (22%) had uncomplicated TBAD with high-risk features and 32 patients (58%) had uncomplicated TBAD. Technical success was 100%. No patient with uncomplicated TBAD died within the first 30 postoperative days. One patient with uncomplicated TBAD had a stroke after TEVAR. Two reinterventions were performed on day 7 and day 9 after TEVAR.Patients with uncomplicated TBAD could be treated by early TEVAR, with a low rate of perioperative complications. In patients with uncomplicated TEVAR and high-risk features, early TEVAR with BMT should be considered as the treatment of choice.

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来源期刊
CiteScore
1.00
自引率
14.30%
发文量
116
审稿时长
6-12 weeks
期刊介绍: Konzentriertes Fachwissen aus Forschung und Praxis Das Zentralblatt für Chirurgie – alle Neuigkeiten aus der Allgemeinen, Viszeral-, Thorax- und Gefäßchirurgie.
期刊最新文献
[Correction: Chylothorax]. [Early Thoracic Endografting is Safe in Patients with Uncomplicated Type B Aortic Dissection]. [Malperfusion after Aortic Dissection - Management and Techniques]. [Outpatient and "Admission-Substituting" Interventions in Vascular Surgery - What is Feasible and Where are the Limits? Previous and New Legal Requirements and their Implementation in Practice]. [Reduced Amputation Rate in Patients with Diabetic Foot Syndrome Since the Introduction of a Minimal-invasive Concept].
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