Nessvi Sofia, Gottsäter Anders, Acosta Stefan
Vascular Center Malmö-Lund, Skåne University Hospital, Malmö, Sweden.
SAGE Open Med. 2014 Jan 28;2:2050312113519986. doi: 10.1177/2050312113519986. eCollection 2014.
To evaluate mid-term survival in patients undergoing elective fenestrated endovascular aneurysm repair and standard endovascular aneurysm repair for abdominal aortic aneurysm.
Consecutive patients treated from 2007 to 2011 with elective fenestrated endovascular aneurysm repair (n = 81) and endovascular aneurysm repair (n = 201) were evaluated concerning age, cardiovascular medication, comorbidities, and mid-term mortality.
Patients in the elective fenestrated endovascular aneurysm repair group were younger than the endovascular aneurysm repair group (p = 0.006). In comparison with the endovascular aneurysm repair group, a lower proportion of patients in the elective fenestrated endovascular aneurysm repair group had diabetes (p = 0.013) and anemia (p = 0.003), and a higher proportion had arterial hypertension (p = 0.009). When entering age, endovascular aneurysm repair or fenestrated endovascular aneurysm repair operation, diabetes, anemia, and hypertension in a Cox regression model, only age (hazard ratio: 1.07; 95% confidence interval: 1.03-1.11; p < 0.001) was a risk factor for mid-term mortality.
Careful patient selection and medical optimization resulted in comparable mid-term survival in patients undergoing elective fenestrated endovascular aneurysm repair and endovascular aneurysm repair.
评估接受选择性开窗式血管内动脉瘤修复术和标准血管内动脉瘤修复术治疗腹主动脉瘤患者的中期生存率。
对2007年至2011年接受选择性开窗式血管内动脉瘤修复术(n = 81)和血管内动脉瘤修复术(n = 201)的连续患者,就年龄、心血管药物治疗、合并症和中期死亡率进行评估。
选择性开窗式血管内动脉瘤修复术组患者比血管内动脉瘤修复术组患者年轻(p = 0.006)。与血管内动脉瘤修复术组相比,选择性开窗式血管内动脉瘤修复术组中患糖尿病(p = 0.013)和贫血(p = 0.003)的患者比例较低,而患动脉高血压的患者比例较高(p = 0.009)。在Cox回归模型中纳入年龄、血管内动脉瘤修复术或开窗式血管内动脉瘤修复术手术、糖尿病、贫血和高血压因素后,只有年龄(风险比:1.07;95%置信区间:1.03 - 1.11;p < 0.001)是中期死亡率的危险因素。
仔细的患者选择和医疗优化使得接受选择性开窗式血管内动脉瘤修复术和血管内动脉瘤修复术的患者中期生存率相当。