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胸主动脉病变血管内治疗的结果:10 年单中心结果。

Outcomes of endovascular treatment of thoracic aorta pathologies: 10-year single-center results.

机构信息

Department of Radiology, Gazi University School of Medicine, Ankara, Turkey.

Department of Cardiovascular Surgery, Gazi University School of Medicine, Ankara, Turkey.

出版信息

Diagn Interv Radiol. 2022 Jul;28(4):370-375. doi: 10.5152/dir.2022.211293.

Abstract

PURPOSE Thoracic endovascular aortic repair (TEVAR) is a safe and effective treatment method for a variety of thoracic aortic pathologies. We aimed to investigate the mortality and complication outcomes and associated factors of TEVAR treatment in Turkey. METHODS In this single-centered retrospective study, patients with thoracic aorta pathologies treated with TEVAR at Gazi University School of Medicine, Department of Radiology, between January 2009 and January 2020 were included. Perioperative, early, and late mortality, complications, and technical success were the outcomes. RESULTS The sample comprised 58 patients with 68 TEVAR interventions. Eleven (16.2%) patients were female, the mean age was 60.1 ± 13.4 years. Emergent TEVAR was required in 20.7% of the patients. The main indications of TEVAR were intact descending aorta aneurysms in 37.9% of the sample, 31.0% Stanford type-B dissection, and 12.1% traumatic transections. The technical success rate of primary and secondary interventions was 98.3% and 100%, respectively. The mortality rate in the first 30 days was 8.6%. Seventeen (29.3%) cases had at least 1 complication related to TEVAR treatment. The most common complication was type-1A endoleak (10.3%). Having acute symptoms, stroke, and acute renal failure were significantly associated with mortality (P=.020, .049, and .009, respectively). CONCLUSION This study reported the outcomes of TEVAR treatment from a tertiary medical center in Turkey over a decade. Patients presenting with acute symptoms and who developed stroke and acute renal failure after the procedure should be carefully followed up as these factors were found to be associated with mortality.

摘要

目的

胸主动脉腔内修复术(TEVAR)是治疗多种胸主动脉病变的安全有效的方法。我们旨在研究土耳其 TEVAR 治疗的死亡率和并发症结局及相关因素。

方法

在这项单中心回顾性研究中,纳入了 2009 年 1 月至 2020 年 1 月期间在加济大学医学院放射科接受 TEVAR 治疗的胸主动脉病变患者。围手术期、早期和晚期死亡率、并发症和技术成功率是研究的结局。

结果

该样本包括 58 例患者的 68 次 TEVAR 干预。11 例(16.2%)患者为女性,平均年龄为 60.1±13.4 岁。20.7%的患者需要紧急 TEVAR。TEVAR 的主要适应证为样本中 37.9%的完整降主动脉动脉瘤、31.0%的 Stanford 型 B 夹层和 12.1%的创伤性横断。初次和二次干预的技术成功率分别为 98.3%和 100%。30 天内死亡率为 8.6%。17 例(29.3%)至少有 1 例与 TEVAR 治疗相关的并发症。最常见的并发症是 1 型内漏(10.3%)。有急性症状、中风和急性肾衰竭与死亡率显著相关(P=.020、.049 和.009)。

结论

本研究报告了土耳其一家三级医疗中心十年来 TEVAR 治疗的结局。有急性症状且在手术后发生中风和急性肾衰竭的患者应密切随访,因为这些因素与死亡率相关。

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Cardiol Clin. 2017 Aug;35(3):387-410. doi: 10.1016/j.ccl.2017.03.007. Epub 2017 May 26.

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