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血管腔内治疗时代腹主动脉瘤的开放手术治疗

Open Treatment of Abdominal Aortic Aneurysm in the Endovascular Era.

作者信息

Ibrahim Abdulhakim, Yordanov Miroslav Dimitrov, Hasso Mohammad, Heine Benjamin, Oberhuber Alexander

机构信息

Department of Vascular and Endovascular Surgery, University Hospital Muenster, 48149 Muenster, Germany.

出版信息

J Clin Med. 2022 May 28;11(11):3050. doi: 10.3390/jcm11113050.

Abstract

The aim of the study was to analyse outcomes and determine the early and late complications in patients after open surgical treatment of AAA in the endovascular era. Two hundred and fourteen patients between January 2012 and December 2021 with open repair in primary infrarenal and juxtarena aneurysm in elective setting were included in the study. Pre-, intra-, and postoperative clinical data were statistically analysed. The mean age of the 214 patients was 65.5 ± 9.3 years. The mean follow-up was 22.1 ± 2.1 months. Men represented the majority of the studied group (85.5%). The mean aortic diameter was 58.2 ± 13.4. The median ICU (days) stay was 5 ± 4.9 days for infrarenal aneurysm and 6 ± 6.1 days for juxtarenal aneurysm. Four patients died within 30 days, giving an in-hospital mortality rate of 1.9%. In multivariate logistic regression, COPD ( = 0.015) was the only predictor significantly associated with the mortality. A comparison of survival and reintervention using a Kaplan-Meier curve showed no significant difference between the groups in terms of risk stratification and the groups with juxtarenal versus infrarenal aneurysms. In conclusion, open aneurysm repair is in the era of endovascular aneurysm repair, being safe and effective, especially when performed in specialised high-volume centres with large expertise.

摘要

本研究的目的是分析血管腔内治疗时代腹主动脉瘤(AAA)开放手术治疗患者的预后,并确定其早期和晚期并发症。本研究纳入了2012年1月至2021年12月期间214例在择期情况下接受原发性肾下和近肾动脉瘤开放修复的患者。对术前、术中和术后的临床数据进行了统计分析。214例患者的平均年龄为65.5±9.3岁。平均随访时间为22.1±2.1个月。男性占研究组的大多数(85.5%)。平均主动脉直径为58.2±13.4。肾下动脉瘤患者在重症监护病房(ICU)的中位住院时间为5±4.9天,近肾动脉瘤患者为6±6.1天。4例患者在30天内死亡,院内死亡率为1.9%。在多因素逻辑回归分析中,慢性阻塞性肺疾病(COPD)(P = 0.015)是与死亡率显著相关的唯一预测因素。使用Kaplan-Meier曲线对生存和再次干预进行比较,结果显示在风险分层方面,肾旁动脉瘤组和肾下动脉瘤组之间没有显著差异。总之,在血管腔内动脉瘤修复时代,开放动脉瘤修复是安全有效的,尤其是在具有丰富专业知识的专业大容量中心进行时。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2754/9181049/6fd6ebdb9eb3/jcm-11-03050-g001.jpg

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