腹主动脉瘤腔内修复术后囊腔消退与临床预后的相关影响:事实还是神话?

IF 2.9 3区 医学 Q3 ENGINEERING, BIOMEDICAL Expert Review of Medical Devices Pub Date : 2023-07-01 DOI:10.1080/17434440.2023.2224502
Mohammed Al-Tawil, Eduardo Muscogliati, Matti Jubouri, Priyanshu Saha, Ravi Patel, Idhrees Mohammed, Damian M Bailey, Ian M Williams, Mohamad Bashir
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引用次数: 0

摘要

血管内动脉瘤修复(EVAR)已迅速成为腹主动脉瘤(AAA)的首选治疗方法。EVAR后囊腔退化状态与临床结果以及EVAR装置的选择有关。这篇叙述性综述的目的是探讨AAA EVAR后囊退化与临床结果之间的关系。另一个目的是比较主要EVAR装置实现的囊退化。涉及领域:我们对多个电子数据库进行了全面的文献检索。囊退化通常定义为随访期间囊直径减小(>10 mm)。这表明,evar后囊退化的个体死亡率显著降低,无事件生存率较高。此外,在消退的动脉瘤囊患者中观察到较低的内漏率和再干预率。与囊腔稳定或囊腔扩张的患者相比,囊腔退化患者破裂的几率也明显降低。EVAR装置的选择也会影响回归,其中开窗的蟒蛇显示出良好的结果。专家意见:AAA evar后囊膜回归是一个重要的预后因素,因为它转化为死亡率和发病率的改善。因此,在后续工作中必须认真考虑这种关系。
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Correlative effect between sac regression and clinical outcomes following endovascular repair in abdominal aortic aneurysm: fact or myth?

Introduction: Endovascular aneurysm repair (EVAR) has rapidly become the preferred management of abdominal aortic aneurysm (AAA). Sac regression status post-EVAR has been linked to clinical outcomes as well as the choice of EVAR device. The aim of this narrative review is to investigate the relationship between sac regression and clinical outcomes post-EVAR in AAA. Another aim is to compare sac regression achieved with the main EVAR devices.

Areas covered: We carried out a comprehensive literature search on multiple electronic databases. Sac regression was usually defined as a decrease in the sac diameter (>10 mm) over follow-up. This revealed that individuals who had sac regression post-EVAR had significantly lower mortality, and higher event-free survival rates. Further, lower rates of endoleak and reintervention were observed in patients with regressing aneurysm sacs. Sac regression patients also had significantly lower odds of rupture compared to counterparts with stable or expanded sacs. The choice of EVAR device was also shown to impact regression, with the Fenestrated Anaconda showing favorable results.

Expert opinion: Sac regression post-EVAR in AAA is an important prognostic factor as it translates to improved mortality and morbidity. Therefore, this relationship must be seriously taken into consideration during follow-up.

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来源期刊
Expert Review of Medical Devices
Expert Review of Medical Devices 医学-工程:生物医学
CiteScore
5.90
自引率
3.20%
发文量
69
审稿时长
6-12 weeks
期刊介绍: The journal serves the device research community by providing a comprehensive body of high-quality information from leading experts, all subject to rigorous peer review. The Expert Review format is specially structured to optimize the value of the information to reader. Comprehensive coverage by each author in a key area of research or clinical practice is augmented by the following sections: Expert commentary - a personal view on the most effective or promising strategies Five-year view - a clear perspective of future prospects within a realistic timescale Key issues - an executive summary cutting to the author''s most critical points In addition to the Review program, each issue also features Medical Device Profiles - objective assessments of specific devices in development or clinical use to help inform clinical practice. There are also Perspectives - overviews highlighting areas of current debate and controversy, together with reports from the conference scene and invited Editorials.
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