Boufi Mourad, Patterson Benjamin O, Grima Matthew Joe, Karthikesalingam Alan, Hudda Mohammed T, Holt Peter J, Loftus Ian M, Thompson Matthew M
St. George's Vascular Institute, St. George's Hospital National Health Service Trust, London, United Kingdom; Department of Vascular Surgery, Assistance Publique-Hôpitaux de Marseille (APHM), University Hospital Nord, Marseille, France; Aix-Marseille Université, Institut Français des Sciences et Technologies des Transports, de l'Aménagement et des Réseaux (IFSTTAR), Unité Mixte de Recherche T24, Marseille, France.
St. George's Vascular Institute, St. George's Hospital National Health Service Trust, London, United Kingdom.
Ann Thorac Surg. 2017 Jun;103(6):1992-2004. doi: 10.1016/j.athoracsur.2016.12.036. Epub 2017 Apr 21.
This review analyzed the incidence, mechanisms, and risk factors of aortic-related reintervention after endovascular repair of chronic dissections. The systematic review identified 28 studies describing 1,249 patients at median 27 months follow-up (range, 10.3 to 64.4). There were six reinterventions, 0.7 ruptures, and 1.2 surgical conversions per 100 patient-years of follow-up. Stent-related reinterventions were more frequent than nonstent related (80.2% vs 19.8%). Distal false lumen perfusion was the most common complication (40.5%). No individual risk factor-treatment timing, disease extent, covered aorta length, or remodelling-was associated with reintervention. Further investigation based on consistent reporting standards is required.
本综述分析了慢性主动脉夹层腔内修复术后主动脉相关再次干预的发生率、机制及危险因素。该系统评价纳入了28项研究，共1249例患者，中位随访时间为27个月（范围10.3至64.4个月）。每100患者年随访中，有6次再次干预、0.7次破裂及1.2次手术转换。支架相关再次干预比非支架相关更常见（80.2%对19.8%）。远端假腔灌注是最常见的并发症（40.5%）。没有个体危险因素——治疗时机、疾病范围、覆膜主动脉长度或重塑——与再次干预相关。需要基于一致的报告标准进行进一步研究。
