[1]袁雪亮,余海彬,王喜明.Stanford B型主动脉夹层行TEVAR干预时机分析[J].介入放射学杂志,2024,33(05):523-527.
 YUAN Xueliang,YU Haibin,WANG Ximing..Analysis of the timing of TEVAR intervention for Stanford type B aortic dissection[J].journal interventional radiology,2024,33(05):523-527.
点击复制

Stanford B型主动脉夹层行TEVAR干预时机分析()

PDF下载中关闭

分享到:

《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
33
期数:
2024年05
页码:
523-527
栏目:
临床研究
出版日期:
2024-06-03

文章信息/Info

Title:
Analysis of the timing of TEVAR intervention for Stanford type B aortic dissection
作者:
袁雪亮 余海彬 王喜明
Author(s):
YUAN Xueliang YU Haibin WANG Ximing.
Department of Cardiovascular Surgery, Second Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province 450003, China
关键词:
【关键词】 干预时机 胸主动脉腔内修复术 Stanford B型主动脉夹层 不良事件
文献标志码:
A
摘要:
【摘要】 目的 探索胸主动脉腔内修复术(thoracic endovascular aortic repair,TEVAR)不同干预时机治疗Stanford B型主动脉夹层后的疗效。方法 回顾性分析2018年1月至2023年4月于我院就诊的126例Stanford B型主动脉夹层患者,根据发病时间至手术时间分为A组(<24 h)、B组(2~7 d)和C组(8~14 d)。比较三组围手术期不良事件(内漏、脑梗死、死亡、主动脉破裂及总并发症等)发生情况,并根据随访情况进行生存分析。结果 本研究共计纳入126例Stanford B型主动脉夹层患者,其中A组50例,B组43例,C组33例。三组在一般情况方面无统计学差异(P>0.05);三组在围手术期急性脑梗死、内漏、感染及死亡发生率方面无统计学差异(P>0.05),在总并发症发生率方面存在统计学差异(P<0.05);应用Log-rank检验比较三组生存曲线,A组5年累计无主动脉夹层复发及生存率低于B组、C组,差异有统计学意义(P<0.05)。结论 本研究认为在症状出现后24 h内行TEVAR治疗B型主动脉夹层不良事件发生率及近中期疗效不佳,而在症状出现2~14 d行TEVAR可获得较好的围手术期及近中期结果。

参考文献/References:

[1] 周 旻,符伟国. Stanford B型主动脉夹层诊断和治疗中国专家共识(2022版)[J]. 中国血管外科杂志(电子版), 2022, 14:119- 130.
[2] Isselbacher EM, Preventza O, Hamilton Black J3, et al. 2022 ACC/AHA guideline for the diagnosis and management of aortic disease: a report of the American heart association/American college of cardiology joint committee on clinical practice guidelines[J]. Circulation, 2022, 146: e334- e482.
[3] Nienaber CA, Erbel R, Ince H. Nihilnocere on the Rocky road to endovascular stent- graft treatment[J]. J Thorac Cardiovasc Surg, 2004, 127: 620- 621.
[4] Liu D, Luo H, Lin S, et al. Comparison of the efficacy and safety of thoracic endovascular aortic repair with open surgical repair and optimal medical therapy for acute type B aortic dissection: a systematic review and meta- analysis[J]. Int J Surg, 2020, 83: 53- 61.
[5] Patterson BO, Cobb RJ, Karthikesalingam A, et al. A systematic review of aortic remodeling after endovascular repair of type B aortic dissection: methods and outcomes[J]. Ann Thorac Surg, 2014, 97: 588- 595.
[6] Lombardi JV,Hughes GC,Appoo JJ,et al. Society for vascular surgery(SVS) and society of thoracic surgeons(STS) reporting standards for type B aortic dissections[J]. J Vasc Surg, 2020, 71: 723- 747.
[7] 于易通,任心爽,尹卫华,等. B型主动脉夹层患者的临床特点及预后随访[J]. 中国循环杂志, 2022, 37:1130- 1137.
[8] Christoph AN,Rachel EC. Management of acute aortic dissection[J]. Lancet, 2015, 385: 800- 811.
[9] Trimarchi S,Gleason TG,Brinster DR,et al. Trends in management and outcomes of type B aortic dissection: a report from the international registry of aortic dissection[J]. Eur J Vasc Endovasc Surg, 2023,66:775-782.
[10] Pape LA,Awais M,Woznicki EM,et al. Presentation, diagnosis, and outcomes of acute aortic dissection: 17- year trends from the international registry of acute aortic dissection[J]. J Am Coll Cardiol, 2015, 66: 350- 358.
[11] Harris KM,Nienaber CA,Peterson MD,et al. Early mortality in type A acute aortic dissection: insights from the international registry of acute aortic dissection[J]. JAMA Cardiol, 2022, 7: 1009- 1015.
[12] Luebke T,Brunkwall J. Type B aortic dissection: areview of prognostic factors and meta- analysis of treatment options[J]. Aorta(Stamford), 2014, 2: 265- 278.
[13]舒 畅. TEVAR在非复杂型B型主动脉夹层中的作用——2022年STS/AATS B型主动脉夹层管理临床实践指南解读[J]. 中国普通外科杂志,2022,31:1557- 1563.
[14] Saricilar EC,Patel K,Gatmaitan R,et al. Editor’s choice-optimal timing of thoracic endovascular aortic repair for uncomplicated type B aortic dissection: a systematic review and meta- analysis[J]. Eur J Vasc Endovasc Surg, 2023, 65:851- 860.
[15] 杨洁连,向定成,肖 华,等. 急性Stanford B型主动脉夹层腔内修复治疗时机与预后的关系[J].中国介入心脏病学杂志,2014, 22:300- 303.
[16] 肖 华, 向定成. 急性B型主动脉夹层腔内修复治疗时机[J].岭南心血管病杂志, 2014 ,20:801- 802.
[17] Matsuda H. Treatment of uncomplicated type B aortic dissection[J]. Gen Thorac Cardiovasc Surg, 2017, 65:74- 79.
[18] Xiang D, Wu F, Chen L, et al. Timing of endovascular repair impacts long- term outcomes of uncomplicated acute type B aortic dissection[J]. J Vasc Surg,2022 ,75:851- 860.
[19] Arima D,Suematsu Y,Yamada R,et al. Early thoracic endovascular aortic repair for type B aortic dissection increases the success of aortic remodeling[J].Ann Vasc Surg,2022 ,84:187- 194.
[20] Miyairi T, Miyata H, Chiba K, et al. Influence of timing after thoracic endovascular aortic repair for acute type B aortic dissection[J]. Ann Thorac Surg, 2018,105:1392- 1396.
[21] 侯钦茂,冯家烜,张荣杰,等. Stanford B型主动脉夹层腔内介入治疗时机对预后的影响[J]. 介入放射学杂志,2018,27:310- 313.
[22] Beck AW,Wang G,Lombardi JV,et al. Impact of thoracic endovascular aortic repair timing on outcomes after uncomplicated type B aortic dissection in the Society for Vascular Surgery Vascular Quality Initiative postapproval project for dissection[J]. J Vasc Surg, 2023, 77:1377- 1386.
[23] Canaud L, Ozdemir BA, Patterson BO, et al. Retrograde aortic dissection after thoracic endovascular aortic repair.[J]. Ann Surg, 2014, 260:389- 395.


相似文献/References:

[1]王豪夫,王曰伟,李 君,等.主动脉瘤腔内修复术一期治愈stanford A型主动脉夹层并腹主动脉瘤一例[J].介入放射学杂志,2011,(01):64.
 WANG Hao-fu,WANG Yue-wei,LI Jun,et al.Endovascular aortic aneurysm repair of Stanford type A aortic dissection accompanied with abdominal aortic aneurysm: report of one case[J].journal interventional radiology,2011,(05):64.
[2]侯钦茂,冯家烜,张荣杰,等.Stanford B型主动脉夹层腔内介入治疗时机对预后的影响 [J].介入放射学杂志,2018,27(04):310.
 HOU Qinmao,FENG Jiaxuan,ZHANG Rongjie,et al.The effect of timing of TEVAR on the prognosis of patients with Stanford type B aortic dissection [J].journal interventional radiology,2018,27(05):310.
[3]王国权,翟水亭,李天晓,等.Stanford B型主动脉夹层腔内修复术后死亡原因分析[J].介入放射学杂志,2015,(11):950.
 WANG Guo- quan,ZHAI Shui- ting,LI Tian- xiao,et al.Analysis of the causes of death in patients with Stanford type B aortic dissection after endovascular repair[J].journal interventional radiology,2015,(05):950.
[4]王江云,陈 勇,李彦豪,等.腔内修复或药物治疗稳定型B型主动脉夹层 [J].介入放射学杂志,2017,(03):266.
 WANG Jiangyun,CHEN Yong,LI Yanhao,et al.Endovascular repair or medication for the management of uncomplicated type B aortic dissection [J].journal interventional radiology,2017,(05):266.
[5]王喜明,张艳霞,余海彬,等.85例Stanford B型主动脉夹层腔内修复治疗体会 [J].介入放射学杂志,2017,(07):651.
 WANG Ximing,ZHANG Yanxia,YU Haibin,et al.Endovascular repair of Stanford type B aortic dissection: initial experience in 85 cases[J].journal interventional radiology,2017,(05):651.
[6]谢小均,刘洪端,白 娇,等.急性主动脉壁内血肿影像学表现与治疗策略[J].介入放射学杂志,2018,27(09):873.
 XIE Xiaojun,LIU Hongduan,BAI Jiao,et al.The imaging characteristics and treatment strategy of acute aortic intramural hematoma [J].journal interventional radiology,2018,27(05):873.
[7]杨素萍,简远熙,张文卿,等.Stanford B型主动脉夹层腔内修复术后Ⅰ型内漏危险因素分析[J].介入放射学杂志,2021,30(08):769.
 YANG Suping,JIAN Yuanxi,ZHANG Wenqing,et al.Analysis of risk factors of type Ⅰ endoleak occurring after thoracic endovascular aortic repair of Stanford type B aortic dissection [J].journal interventional radiology,2021,30(05):769.
[8]葛 静,刘建平,张永恒,等.急性期Stanford B型主动脉夹层患者腔内修复术后主动脉重塑[J].介入放射学杂志,2021,30(11):1113.
 GE Jing,LIU Jianping,ZHANG Yongheng,et al.Remodeling of aorta after thoracic endovascular aortic repair in patients with acute Stanford type B aortic dissection[J].journal interventional radiology,2021,30(05):1113.

备注/Memo

备注/Memo:
(收稿日期:2023- 06- 30)
(本文编辑:茹 实)
更新日期/Last Update: 2024-06-03