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介入性缩窄成形术后的早期和中期结果:对影响结果的变量的评估

Early and Midterm Results Following Interventional Coarctoplasty: Evaluation of Variables that Can Affect the Results.

作者信息

Bassiri Hossein Ali, Abdi Seifollah, Shafe Omid, Sarpooshi Javad

机构信息

Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.

出版信息

Korean Circ J. 2017 Jan;47(1):97-106. doi: 10.4070/kcj.2016.0211. Epub 2016 Dec 27.

Abstract

BACKGROUND AND OBJECTIVES

Stent coarctoplasty has been approved as the treatment of choice for adult patients with coarctation of the aorta. We have evaluated the early and midterm clinical and procedural results after interventional coarctoplasty. Also, variables that can affect these results were evaluated.

SUBJECTS AND METHODS

Gathering clinical, angiographic and procedural data, we evaluated the pre-specified outcomes, including procedural success, complications, the incidence of hypertension after coarctoplasty etc., after the procedure. The effect of pre-specified variables including aortic arch shape, coarctation type and etc. on the procedural result was evaluated.

RESULTS

Between February 2005 through March 2014, 133 stent coarctoplasty procedures were performed. Median age was 23.5 years old (interquartile range [IQR]:19-28), and 105 (71.9%) were male. Nearly all of the patients were undergone stent coarctoplasty, mostly with cheatham platinum (CP) stents. There was no association between aortic arch morphology and acute procedural complications. Balloon length more than 40 mm (p=0.028), aorta diameter at the site of Coarctation larger than 2.35 mm (p=0.008) was associated with higher rate of restenosis during follow-up. Comparison between the prevalence of hypertension (HTN) before and after coarctoplasty showed a significant reduction in the prevalence of HTN (117 [91.4%] vs. 95 [74.2%] p<0.001).

CONCLUSION

Stent coarctoplasty is a low-risk procedure with favorable early and delayed outcomes. Most mortality is related to the patient's comorbid conditions and not to the procedure.

摘要

背景与目的

支架缩窄成形术已被批准为成人主动脉缩窄患者的首选治疗方法。我们评估了介入性缩窄成形术后的早期和中期临床及手术结果。此外,还评估了可能影响这些结果的变量。

对象与方法

收集临床、血管造影和手术数据,我们评估了预先设定的结果,包括手术成功率、并发症、缩窄成形术后高血压的发生率等。评估了预先设定的变量,包括主动脉弓形状、缩窄类型等对手术结果的影响。

结果

2005年2月至2014年3月期间,共进行了133例支架缩窄成形术。中位年龄为23.5岁(四分位间距[IQR]:19 - 28),男性105例(71.9%)。几乎所有患者都接受了支架缩窄成形术,大多数使用Cheatham Platinum(CP)支架。主动脉弓形态与急性手术并发症之间无关联。球囊长度超过40 mm(p = 0.028)、缩窄部位的主动脉直径大于2.35 mm(p = 0.008)与随访期间较高的再狭窄率相关。缩窄成形术前和术后高血压(HTN)患病率的比较显示,HTN患病率显著降低(117例[91.4%] vs. 95例[74.2%],p<0.001)。

结论

支架缩窄成形术是一种低风险手术,早期和延迟结果良好。大多数死亡与患者的合并症有关,而非手术本身。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9a2a/5287194/d02813602937/kcj-47-97-g001.jpg

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