[1]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):769-773.
 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(08):769-773.
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Stanford B型主动脉夹层腔内修复术后Ⅰ型内漏危险因素分析()

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

卷:
30
期数:
2021年08
页码:
769-773
栏目:
血管介入
出版日期:
2021-08-25

文章信息/Info

Title:
Analysis of risk factors of type Ⅰ endoleak occurring after thoracic endovascular aortic repair of Stanford type B aortic dissection
作者:
杨素萍 简远熙 张文卿 杨 帆 张 娅 王家平
Author(s):
YANG Suping JIAN Yuanxi ZHANG Wenqing YANG Fan ZHANG Ya WANG Jiaping.
Department of Radiology, Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan Province 650101, China
关键词:
【关键词】 主动脉夹层 胸主动脉腔内修复术 内漏
文献标志码:
A
摘要:
【摘要】 目的 探讨Stanford B型主动脉夹层(AD)患者胸主动脉腔内修复术(TEVAR)后Ⅰ型内漏发生的危险因素。方法 回顾性分析2014年6月至2019年6月在昆明医科大学第二附属医院接受TEVAR 术的Stanford B型AD患者临床资料。根据术后有无内漏分为内漏组、无内漏组。比较两组患者一般资料、术前影像学特点、手术资料差异。采用多因素logistic回归法分析TEVAR术后Ⅰ型内漏危险因素。结果 共纳入49例患者,其中内漏组14例,无内漏组35例。两组患者一般资料、手术资料差异均无统计学意义(P>0.05)。内漏组、无内漏组患者主动脉弓曲率半径(RoC)分别为(23.43±3.98) mm、(30.85±4.33) mm,差异有显著统计学意义(P<0.001);近端锚定区长度分别为(13.23±6.71) mm、(32.85±14.97) mm,差异有显著统计学意义(P<0.001);其余影像学特点比较,差异均无统计学意义(P>0.05)。多因素logistic回归分析显示,主动脉弓RoC(OR=0.664,95%CI=0.468~0.942, P=0.022)、近端锚定区长度(OR=0.833,95%CI=0.719~0.964,P=0.014)是TEVAR术后患者Ⅰ型内漏的危险因素。结论 主动脉弓RoC和近端锚定区长度是Stanford B型AD患者TEVAR术后Ⅰ型内漏的危险因素。

参考文献/References:

[1] Harky A, Chan J, Wong C, et al. Systematic review and meta- analysis of acute type B thoracic aortic dissection, open, or endovascular repair[J]. J Vasc Surg, 2019, 69: 1599.e2- 1609.e2.
[2] Zhang L, Zhou J, Lu Q, et al. Potential risk factors of re- intervention after endovascular repair for type B aortic dissections[J]. Catheter Cardiovasc Interv, 2015, 86: E1- E10.
[3] Zhang L, Zhao Z, Chen Y, et al. Reintervention after endovascular repair for aortic dissection: a systematic review and meta- analysis[J]. J Thorac Cardiovasc Surg, 2016, 152: 1279.e3- 1288.e3.
[4] 景在平,冯 翔. 主动脉夹层腔内隔绝术[M]. 北京:人民军医出版社, 2008:202- 209.
[5] Alberta HB, Secor JL, Smits TC, et al. Differences in aortic arch radius of curvature, neck size, and taper in patients with traumatic and aortic disease[J]. J Surg Res, 2013, 184: 613- 618.
[6] Eggebrecht H, Nienaber CA, Neuhauser M, et al. Endovascular stent- graft placement in aortic dissection: a meta- analysis[J]. Eur Heart J, 2006, 27: 489- 498.
[7] Zhao Y, Cui J, Yin H, et al. Hybrid operation versus the chimney technique for reconstruction of a single aortic arch branch: a single- centre experience[J]. Interact Cardiovasc Thorac Surg, 2017, 25: 575- 581.
[8] Chiu P, Lee HP, Venkatesh SK, et al. Anatomical characteristics of the thoracic aortic arch in an Asian population[J]. Asian Car- diovasc Thorac Ann, 2013, 21: 151- 159.
[9] Malkawi AH, Hinchliffe RJ, Yates M, et al. Morphology of aortic arch pathology: implications for endovascular repair[J]. J Endovasc Ther, 2010, 17: 474- 479.
[10] Sze DY, van den Bosch MA, Dake MD, et al. Factors portending endoleak formation after thoracic aortic stent- graft repair of complicated aortic dissection[J]. Circ Cardiovasc Interv, 2009, 2: 105- 112.
[11] Nakatamari H, Ueda T, Ishioka F, et al. Discriminant analysis of native thoracic aortic curvature: risk prediction for endoleak formation after thoracic endovascular aortic repair[J]. J Vasc Interv Radiol, 2011, 22: 974- 979.
[12] Poullis MP, Warwick R, Oo A, et al. Ascending aortic curvature as an independent risk factor for type A dissection, and ascending aortic aneurysm formation: a mathematical model[J]. Eur J Cardiothorac Surg, 2008, 33: 995- 1001.
[13] 朱水波,朱 健,郗二平,等. 胸主动脉腔内修复术治疗复杂性胸主动脉夹层的临床疗效[J]. 中国循环杂志, 2016, 31:789- 792.
[14] Zhang S,Shen Y,Zhu G, et al. Risk factors of distal segment aortic enlargement after complicated type B aortic dissection[J]. J Intervent Med, 2019, 2:154- 159.
[15] Fanelli F, Cannavale A, O’Sullivan GJ, et al. Endovascular repair of acute and chronic aortic type B dissections: main factors affecting aortic remodeling and clinical outcome[J]. JACC Cardiovasc Interv, 2016, 9: 183- 191.
[16] 许 果,黄连军,黄小勇,等. Stanford B型主动脉夹层近端锚定区不足腔内治疗分析[J]. 介入放射学杂志, 2016, 25:849- 852.
[17] 张 省,秦金保,李维敏,等. 拓展近端锚定区对Stanford B型主动脉夹层腔内修复术预后的影响[J]. 中华外科杂志, 2018,56:760- 763.
[18] Moulakakis KG, Mylonas SN, Avgerinos E, et al. The chimney graft technique for preserving visceral vessels during endovas- cular treatment of aortic pathologies[J]. J Vasc Surg, 2012, 55: 1497- 1503.
[19] Mangialardi N, Ronchey S, Malaj A, et al. Value and limitations of chimney grafts to treat arch lesions[J]. J Cardiovasc Surg(Torino), 2015, 56: 503- 511.
[20] Wang T, Shu C, Li M, et al. Thoracic endovascular aortic repair with single/double chimney technique for aortic arch pathologies[J]. J Endovasc Ther, 2017, 24: 383- 393.
[21] 张玉京,王 亮,刘江龙,等. 体外支架开窗及开槽加分支支架技术在近端锚定区不足患者的胸主动脉腔内治疗中的应用[J]. 中华胸心血管外科杂志, 2017, 33:245- 247.

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备注/Memo

备注/Memo:
(收稿日期:2020- 04- 27)
(本文编辑:边 佶)
更新日期/Last Update: 2021-08-18