Lin Peter H, Kougias Panagiotis, Bechara Carlos F, Weakley Sarah M, Bakaeen Faisal G, Lemaire Scott A, Coselli Joseph S
Michael E. DeBakey VA Medical Center, Department of Surgery, Houston, TX 77030, USA.
Perspect Vasc Surg Endovasc Ther. 2012 Mar;24(1):5-13. doi: 10.1177/1531003511432768. Epub 2012 Feb 8.
Although visceral vessel debranching and endovascular aneurysm exclusion represents a hybrid treatment approach in patients with thoracoabdominal aortic aneurysm, the effect of timing with regard to the visceral debranching procedure and endovascular aneurysm exclusion in this treatment strategy remains unclear. In this study, the authors analyzed their recent institutional experience of visceral debranching and aneurysm stent-grafting procedures. Specifically, the authors compared the effect of staged (n = 27) versus combined (n = 31) hybrid treatment in patients with complex aortic aneurysms. This study showed a higher incidence of renal insufficiency in patients undergoing a combined hybrid repair than the staged hybrid approach. The possibility of aneurysm rupture may exist in the staged treatment approach if the duration of staged repair is prolonged. The combined hybrid treatment strategy should be performed with caution as it is associated with significantly higher complication rates than the staged hybrid treatment modality.
尽管对于胸腹主动脉瘤患者，内脏血管去分支和血管腔内动脉瘤隔绝术是一种混合治疗方法，但在这种治疗策略中，内脏去分支手术和血管腔内动脉瘤隔绝术的时间安排效果仍不明确。在本研究中，作者分析了他们近期在机构内进行内脏去分支和动脉瘤支架植入手术的经验。具体而言，作者比较了分期（n = 27）与联合（n = 31）混合治疗对复杂主动脉瘤患者的效果。这项研究表明，接受联合混合修复的患者发生肾功能不全的发生率高于分期混合治疗方法。如果分期修复的时间延长，分期治疗方法可能存在动脉瘤破裂的风险。联合混合治疗策略应谨慎实施，因为它与明显高于分期混合治疗方式的并发症发生率相关。
