SingVaSC, Singapore Vascular Surgical Collaborative; Yong Loo Lin School of Medicine, National University of Singapore.
SingVaSC, Singapore Vascular Surgical Collaborative.
J Cardiol. 2018 Nov;72(5):369-376. doi: 10.1016/j.jjcc.2018.04.009. Epub 2018 May 24.
The caval-aortic path is a novel access route for endovascular aortic interventions in aortic interventions, particularly for patients unsuitable for traditional access routes including femoral, subclavian, transapical, and aortic. A systematic review was conducted as per the PRISMA guidelines utilizing three electronic databases: Medline, Embase, and Cochrane database. There were 10 studies identified, including 7 retrospective studies, 1 prospective cohort study, and 2 case reports. Data on 209 patients (mean age 79.5±5.1 years; 51.2% male) were abstracted including preoperative work-up, technical procedure details, and outcomes. The overall technical success rate for all procedures is 96.2%, with a 4.3% mortality rate and a mean follow up of 17.9±19.8 months. Individually in the various interventions, the technical success rate of transcaval endoleak repair and transcatheter aortic valve implantation (TAVI) was 94.4% and 97.5% respectively, with a low 30-day mortality rate of 7.6% in the TAVI intervention. There is encouraging evidence regarding the rates of mortality and complications in the transcaval approach for endovascular aortic interventions. It presents a feasible alternative for a judiciously select group of patients who are not suitable for other access routes.
经腔静脉-主动脉途径是一种新的血管内主动脉介入治疗途径，特别是对于不适合传统途径（包括股动脉、锁骨下动脉、经心尖和主动脉途径）的患者。按照 PRISMA 指南进行了系统评价，使用了三个电子数据库：Medline、Embase 和 Cochrane 数据库。共确定了 10 项研究，包括 7 项回顾性研究、1 项前瞻性队列研究和 2 项病例报告。共提取了 209 例患者（平均年龄 79.5±5.1 岁，51.2%为男性）的术前检查、技术程序细节和结果数据。所有手术的总体技术成功率为 96.2%，死亡率为 4.3%，平均随访时间为 17.9±19.8 个月。在各种介入手术中，经腔静脉腔内漏修复和经导管主动脉瓣植入术的技术成功率分别为 94.4%和 97.5%，经导管主动脉瓣植入术的 30 天死亡率为 7.6%。经腔静脉途径进行血管内主动脉介入治疗的死亡率和并发症发生率方面有令人鼓舞的证据。对于不适合其他途径的患者，这是一种合理选择的可行替代方法。
