经皮冠状动脉介入治疗后的早期血管内动脉瘤修复术。

Early endovascular aneurysm repair after percutaneous coronary interventions.

作者信息

Pecoraro Felice, Wilhelm Markus, Kaufmann Angela R, Bettex Dominique, Maier Willibald, Mayer Dieter, Veith Frank J, Lachat Mario

机构信息

Clinic for Cardiovascular Surgery, University Hospital Zurich, Zurich, Switzerland; Vascular Surgery Unit, University of Palermo, AOUP "P. Giaccone," Palermo, Italy.

Clinic for Cardiovascular Surgery, University Hospital Zurich, Zurich, Switzerland.

出版信息

J Vasc Surg. 2015 May;61(5):1146-50. doi: 10.1016/j.jvs.2014.12.044. Epub 2015 Feb 2.

DOI:10.1016/j.jvs.2014.12.044

PMID:25656589

Abstract

OBJECTIVE

The objective of this study was to report long-term results of early endovascular aortic aneurysm repair after percutaneous coronary intervention (PCI).

METHODS

This was a retrospective analysis of all patients presenting with abdominal aortic aneurysm and coronary artery disease treated during the same hospitalization by endovascular aortic aneurysm repair performed soon after PCI. Primary outcomes were perioperative mortality, perioperative complications, survival after treatment, and freedom from reintervention.

RESULTS

A total of 20 patients were included, and all completed both procedures. No deaths or abdominal aortic aneurysm ruptures occurred between the PCI and the aortic intervention. Perioperative mortality was 5% as one patient died of mesenteric ischemia after endovascular aneurysm repair. Major cardiovascular vascular complications occurred in four patients (20%) and included non-ST-segment elevation myocardial infarction (one) and access vessel complication (three). Mean follow-up was 94 (range, 1-164; standard deviation, 47) months. Estimated survival at 1 year, 2 years, 5 years, and 10 years was 90%, 90%, 90%, and 60%, respectively. A reoperation was required in six patients. Estimated freedom from reintervention at 1 year, 2 years, 5 years, and 10 years was 83%, 83%, 78%, and 72%, respectively.

CONCLUSIONS

Our study indicates that early endovascular aneurysm repair performed within a week after PCI may be a reasonable approach in patients with large or symptomatic aneurysms.

摘要

目的

本研究的目的是报告经皮冠状动脉介入治疗（PCI）后早期血管内主动脉瘤修复的长期结果。

方法

这是一项对所有在同一住院期间接受治疗的腹主动脉瘤和冠状动脉疾病患者的回顾性分析，这些患者在PCI后不久接受了血管内主动脉瘤修复。主要结局指标为围手术期死亡率、围手术期并发症、治疗后的生存率以及无需再次干预。

结果

共纳入20例患者，所有患者均完成了这两种手术。在PCI和主动脉介入之间未发生死亡或腹主动脉瘤破裂。围手术期死亡率为5%，因为有1例患者在血管内动脉瘤修复后死于肠系膜缺血。4例患者（20%）发生了主要心血管并发症，包括非ST段抬高型心肌梗死（1例）和入路血管并发症（3例）。平均随访时间为94（范围1 - 164；标准差47）个月。1年、2年、5年和10年的估计生存率分别为90%、90%、90%和60%。6例患者需要再次手术。1年、2年、5年和10年无需再次干预的估计概率分别为83%、83%、78%和72%。