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患有全身性结缔组织疾病患者的主动脉腔内支架置入术:这条严格的教条是否仍然坚不可摧?

Aortic endovascular stenting in patients with systemic connective tissue disorders: does the prohibitive dogma still stand tall?

作者信息

Harky Amer, Iqbal Rizwan, Giordano Vincenzo, Al-Adhami Ahmed

机构信息

Department of Cardiothoracic Surgery, Liverpool Heart and Chest, Liverpool, UK.

Department of Cardiothoracic Surgery, Royal Infirmary of Edinburgh, Edinburgh, UK.

出版信息

J Int Med Res. 2020 Feb;48(2):300060519863963. doi: 10.1177/0300060519863963. Epub 2019 Jul 29.

Abstract

Endovascular repair of thoracic aortic diseases can provide satisfactory outcomes in elective and certain emergency cases involving the descending thoracic and aortic arch. However, open repair remains the gold standard method of aortic root pathologies and certain aortic arch pathologies, such as extended dissection. Nevertheless, the use of endovascular stenting in patients with connective tissue disorders has not been fully explored because the aortic tissues are fragile and the likelihood of keeping the stent in place is low because of its progressive dilatation and subsequent requirement for open repair at a later stage when the stent graft fails. Our brief review focuses on current evidence of the use of stents in patients with connective tissue disorders and whether such practice can be expanded further.

摘要

胸主动脉疾病的血管内修复术在涉及降主动脉和主动脉弓的择期及某些急诊病例中可提供满意的治疗效果。然而,开放修复仍是主动脉根部病变及某些主动脉弓病变(如广泛夹层)的金标准治疗方法。尽管如此,在结缔组织疾病患者中使用血管内支架的情况尚未得到充分研究,因为主动脉组织脆弱,且由于其逐渐扩张以及随后在支架移植物失效时需要在后期进行开放修复,所以支架在位的可能性较低。我们的简要综述聚焦于目前在结缔组织疾病患者中使用支架的证据,以及这种做法是否可以进一步推广。

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