Patel Priya B, Schermerhorn Marc L
Division of Vascular and Endovascular Surgery, Department of Surgery, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA.
Division of Vascular and Endovascular Surgery, Department of Surgery, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA -
J Cardiovasc Surg (Torino). 2020 Dec;61(6):675-680. doi: 10.23736/S0021-9509.20.11595-7. Epub 2020 Nov 13.
The use of thoracic endovascular aortic repair (TEVAR) has rapidly increased following Food and Drug Administration (FDA) approval in 2005. Initially used for the repair of intact thoracic aneurysms and aortic dissections, TEVAR is now routinely used for the treatment of ruptured thoracic aortic aneurysm as well. Emergent TEVAR for the repair of ruptured aneurysm has demonstrated improved perioperative mortality and morbidity compared to traditional open repair. Spinal cord ischemia and permanent paraplegia rates are also lower following TEVAR compared to open repair. However, TEVAR requires routine surveillance and has demonstrated the need for reintervention compared to open repair. Furthermore, the perioperative survival benefits of TEVAR were attenuated on mid-term and long-term survival analysis.
自2005年获得美国食品药品监督管理局(FDA)批准以来,胸主动脉腔内修复术(TEVAR)的应用迅速增加。TEVAR最初用于完整胸主动脉瘤和主动脉夹层的修复,现在也常规用于治疗破裂性胸主动脉瘤。与传统开放修复相比,用于修复破裂性动脉瘤的急诊TEVAR已显示出围手术期死亡率和发病率有所改善。与开放修复相比,TEVAR术后脊髓缺血和永久性截瘫的发生率也更低。然而,与开放修复相比,TEVAR需要常规监测,并且已显示出再次干预的必要性。此外,在中期和长期生存分析中,TEVAR的围手术期生存益处有所减弱。