Department of Cardiovascular Surgery, University Hospital Berne, Berne, Switzerland.
Ann Thorac Surg. 2011 Aug;92(2):562-6; discussion 566-7. doi: 10.1016/j.athoracsur.2011.02.087. Epub 2011 Jun 25.
Results after thoracic endovascular aortic repair in penetrating atherosclerotic ulcers are uncertain.
From 1997 to 2010, 72 patients (median age, 67 years) presented with penetrating atherosclerotic ulcers (symptomatic, 58%; rupture, 36%). Median logistic EuroSCORE (European System for Cardiac Operative Risk Evaluation) was 32. Mean follow-up was 42 months (range, 19 to 56 months). In-hospital mortality, occurrence of endoleaks, reinterventions, and survival were recorded.
In hospital mortality was 4%. The primary success rate was 100%. Actuarial survival rates at 1, 5, and 10 years were 93%, 72%, and 60%. The early type I and III endoleak rate was 2.7%. The late type I and III endoleak rate was 4%. One late surgical conversion was performed. Aortic-related actuarial survival was 100% at 1 year and 98.6% at 5 and 10 years. Age older than 75 years (odds ratio, 8.928; 95% confidence interval, 2.05 to 38.93) was an independent predictor of survival. During follow-up, 21% of patients underwent a cardiovascular intervention.
Results after thoracic endovascular aortic repair in patients with penetrating atherosclerotic ulcers are excellent for early and late type I and III endoleak formation and aortic-related survival. Patients are mainly limited by age and by the aggressive underlying obliterative atherosclerotic process.
穿透性粥样硬化性溃疡的胸主动脉腔内修复术的结果尚不确定。
1997 年至 2010 年，72 例患者（中位年龄 67 岁）出现穿透性粥样硬化性溃疡（有症状者 58%，破裂者 36%）。中位 logistic EuroSCORE（欧洲心脏手术风险评估系统）为 32。平均随访时间为 42 个月（19 至 56 个月）。记录住院死亡率、内漏发生、再次干预和生存情况。
住院死亡率为 4%。主要手术成功率为 100%。1、5、10 年的累积生存率分别为 93%、72%和 60%。早期Ⅰ型和Ⅲ型内漏发生率为 2.7%。晚期Ⅰ型和Ⅲ型内漏发生率为 4%。1 例晚期行手术转换。主动脉相关的 1 年和 5 年及 10 年累积生存率分别为 100%和 98.6%。年龄大于 75 岁（优势比 8.928；95%置信区间 2.05 至 38.93）是生存的独立预测因素。随访期间，21%的患者接受了心血管介入治疗。
胸主动脉腔内修复术治疗穿透性粥样硬化性溃疡患者的早期和晚期Ⅰ型和Ⅲ型内漏形成和主动脉相关生存率均较好。患者主要受年龄和侵袭性闭塞性动脉粥样硬化过程的限制。
