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血管内支架移植物修复锁骨下动脉真性和创伤性假性动脉瘤。

Endovascular Stent Graft Repair for True and Post-Traumatic False Aneurysms of the Subclavian Artery.

机构信息

Department of Vascular Surgery, Qilu Hospital, Shandong University, Jinan, People's Republic of China; Department of Pharmacology, School of Basic Medical Sciences, Shandong University, Jinan, People's Republic of China.

Department of Cardiovascular Surgery, Central People's Hospital of Tengzhou, Tengzhou, People's Republic of China.

出版信息

Ann Vasc Surg. 2021 Aug;75:301-307. doi: 10.1016/j.avsg.2021.01.114. Epub 2021 Apr 3.

Abstract

OBJECTIVE

Subclavian artery aneurysms (SAAs) are uncommon but life-threatening, and a standard treatment approach has yet to be established. The current study aimed to assess the safety and efficacy of endovascular treatment for SAAs.

METHODS

The clinical data of 18 SAA patients who underwent endovascular repair at 3 hospitals from January 2009 to December 2019 were retrospectively collected and analyzed.

RESULTS

Eighteen patients (12 men and 6 women) with a mean age of 61 years were included. Six patients (33.3%) had a history of hypertension, and 5 (27.8%) had a history of chest trauma. Five patients (27.8%) were asymptomatic. Thirteen (72.2%) SAAs were true aneurysms, and the others (27.8%) were posttraumatic false aneurysms. Endovascular stent graft repair was performed in all patients without conversion to open surgery. The immediate technique success rate was 94.4%, with no postoperative death and only one case (5.6%) of endoleak that was observed on intraoperative angiography and later resolved spontaneously. All patients survived over a median follow-up time of 57 months. Follow-up imaging showed that all stent grafts remained patent, with no endoleak.

CONCLUSIONS

Endovascular stent graft repair is feasible, safe, and effective for true and posttraumatic false SAAs and represents a promising treatment option for these SAAs.

摘要

目的

锁骨下动脉动脉瘤(subclavian artery aneurysms,SAAs)较为少见,但却有生命危险,目前尚未建立标准的治疗方法。本研究旨在评估血管内治疗 SAAs 的安全性和有效性。

方法

回顾性收集了 2009 年 1 月至 2019 年 12 月 3 家医院 18 例 SAA 患者的临床资料并进行分析。

结果

18 例患者(男 12 例,女 6 例),平均年龄 61 岁。6 例(33.3%)有高血压病史,5 例(27.8%)有胸部外伤史。5 例(27.8%)患者无症状。13 例(72.2%)SAAs 为真性动脉瘤,其余 5 例(27.8%)为创伤后假性动脉瘤。所有患者均行血管内支架移植物修复,无一例转为开放手术。即刻技术成功率为 94.4%,术后无死亡病例,仅 1 例(5.6%)术中血管造影发现内漏,后自发缓解。所有患者中位随访时间为 57 个月。随访影像学检查显示所有支架移植物均保持通畅,无内漏。

结论

血管内支架移植物修复术对于真性和创伤后假性 SAA 是可行、安全且有效的,是治疗此类 SAA 的一种有前途的选择。

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