经腋/锁骨入路行经导管主动脉瓣植入术治疗股动脉入路不可能的患者的肾脏保护。
Renal protection of transaxillary/subclavian accesses for transcatheter aortic valve implantation in patients with impossible femoral access.
机构信息
Service de médecine intensive - réanimation, Hôpitaux universitaires Paris-Saclay, Hôpital de Bicêtre, APHP, Le Kremlin-Bicêtre, France.
Inserm UMR S_999, Univ Paris-Saclay, Le Kremlin-Bicêtre, France.
出版信息
Scand Cardiovasc J. 2021 Oct;55(5):297-299. doi: 10.1080/14017431.2021.1970802. Epub 2021 Aug 27.
Acute kidney injury (AKI) is a common postoperative complication after transcatheter aortic valve replacement (TAVR). In patients with ineligible femoral access, transaxillary/subclavian (TAx/TSc) might be competitive alternative access. With nine cohort studies and 4995 patients, we found that TAx/TSc access was associated with decreased incidences of AKI (Relative risk [RR]: 0.573, 95% confidence interval [CI]:0.456-0.718, < .001) and stage 3 AKI (RR 0.460, 95%CI 0.318-0.665, < .001) by comparison with intrathoracic approaches. Our findings suggest that TAx/TSc is associated with a reduced AKI risk after TAVR in patients with impossible femoral access.
急性肾损伤（AKI）是经导管主动脉瓣置换术（TAVR）后的常见术后并发症。在股动脉入路不合适的患者中，经腋/锁骨下（TAx/TSc）可能是一种有竞争力的替代入路。通过 9 项队列研究和 4995 例患者，我们发现与经胸入路相比，TAx/TSc 入路与 AKI 发生率降低相关（相对风险 [RR]：0.573，95%置信区间 [CI]：0.456-0.718， < .001）和 3 期 AKI（RR 0.460，95%CI 0.318-0.665， < .001）。我们的研究结果表明，在股动脉入路不可能的患者中，TAx/TSc 与 TAVR 后 AKI 风险降低相关。
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