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急性主动脉综合征的血管内治疗

Endovascular treatment for acute aortic syndrome.

作者信息

Araújo Paula Vasconcelos, Joviliano Edwaldo Edner, Ribeiro Maurício Serra, Dalio Marcelo Bellini, Piccinato Carlos Eli, Moriya Takachi

机构信息

Division of Vascular and Endovascular Surgery, Department of Surgery and Anatomy, Ribeirão Preto School of Medicine, University of São Paulo, São Paulo, Brazil.

出版信息

Ann Vasc Surg. 2012 May;26(4):516-20. doi: 10.1016/j.avsg.2011.07.011. Epub 2011 Nov 1.

Abstract

BACKGROUND

The term "acute aortic syndrome" (AAS) includes conditions of high mortality, such as ruptured aneurysm, pseudoaneurysm and, aortic dissection. Open surgery for these cases has demonstrated unsatisfactory results, and endovascular treatment has become an excellent alternative.

METHODS

We performed a retrospective review of patients with AAS who underwent endovascular treatment in our emergency department from July 2009 to February 2011. They represent 64% (16 of 25) of all patients with AAS seen during this period.

RESULTS

Sixteen patients underwent endovascular treatment: eight ruptured aneurysms, six aortic dissections, one nonruptured painful aneurysm, and one pseudoaneurysm. No intramural hematoma or penetrating atherosclerotic ulcer was found. The mean age was 64.3 years, and arterial hypertension (100%) and smoking (64.7%) were the major comorbidities. Technical success rate was 93%, and overall 30-day mortality was 6.25%.

CONCLUSION

Endovascular treatment for AAS was feasible. Technical success, 30-day mortality, hospital stay, and procedure time were similar to those of the other series reported in the literature, and the endovascular approach has became the main technique for AAS in our hospital.

摘要

背景

“急性主动脉综合征”(AAS)一词包括高死亡率的疾病,如动脉瘤破裂、假性动脉瘤和主动脉夹层。这些病例的开放手术效果并不理想,而血管内治疗已成为一种很好的替代方法。

方法

我们对2009年7月至2011年2月在我们急诊科接受血管内治疗的AAS患者进行了回顾性研究。他们占在此期间所见所有AAS患者的64%(25例中的16例)。

结果

16例患者接受了血管内治疗:8例动脉瘤破裂、6例主动脉夹层、1例未破裂的疼痛性动脉瘤和1例假性动脉瘤。未发现壁内血肿或穿透性动脉粥样硬化溃疡。平均年龄为64.3岁,主要合并症为动脉高血压(100%)和吸烟(64.7%)。技术成功率为93%,30天总死亡率为6.25%。

结论

AAS的血管内治疗是可行的。技术成功率、30天死亡率、住院时间和手术时间与文献中报道的其他系列相似,血管内治疗方法已成为我院治疗AAS的主要技术。

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