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无名动脉狭窄或闭塞不同治疗方法的结果的系统评价和荟萃分析。

Systematic Review and Meta-Analysis of the Outcome of Different Treatments for Innominate Artery Stenosis or Occlusion.

机构信息

Vascular Surgery, Department of Medicine and Surgery, University of Parma, Parma, Italy.

Vascular Surgery, Cardio-Thoracic and Vascular Department, University Hospital of Parma, Parma, Italy.

出版信息

Angiology. 2024 Apr;75(4):314-322. doi: 10.1177/00033197231162179. Epub 2023 Mar 9.

Abstract

The present study reported the outcomes of different treatments for innominate artery (IA) atherosclerotic stenosis or occlusion. We performed a systematic review of the literature (4 database searched; last search February 2022), including articles with ≥5 patients. We performed meta-analyses of proportions for different postoperative outcomes. Fourteen studies were included (656 patients; 396 underwent surgery, 260 endovascular procedures). IA lesions were asymptomatic in 9.6% (95% CI 4.6-14.6). Overall estimated technical success (TS) rate was 91.7% (95% CI 86.9-96.4); weighted TS rate was 86.8% (95% CI 75-98.6) in the surgical group (SG), 97.1% (95% CI 94.6-99.7) in the endovascular group (EG). Postoperative stroke in SG was 2.5% (95% CI 1-4.1) and 2.1% in EG (95% CI .3-3.8). Overall, 30-day occlusion was estimated .9% (95% CI 0-1.8) in SG and .7% (95% CI 0-1.7) in EG. Thirty-day mortality was 3.4% (95% CI .9-5.8) in SG and .7% (95% CI 0-1.7) in EG. Estimated mean follow-up after intervention was 65.5 months (95% CI 45.5-85.5) in SG and 22.4 months (95% CI 14.72-30.16) in EG. During follow-up, restenosis in SG were 2.8% (95% CI .5-5.1) and 16.6% (95% CI 5- 28.1) in EG. In conclusion, the endovascular approach seems to offer good short to mid-term outcomes, but with a higher rate of restenosis during follow-up.

摘要

本研究报告了不同治疗方案治疗无名动脉(IA)粥样硬化性狭窄或闭塞的结果。我们对文献进行了系统评价(4 个数据库检索;最后一次检索时间为 2022 年 2 月),纳入了至少有 5 例患者的文章。我们对不同术后结局的比例进行了荟萃分析。共纳入 14 项研究(656 例患者;396 例接受手术治疗,260 例接受血管内治疗)。IA 病变无症状的占 9.6%(95%CI:4.6-14.6)。总体估计技术成功率(TS)为 91.7%(95%CI:86.9-96.4);手术组(SG)加权 TS 率为 86.8%(95%CI:75-98.6),血管内组(EG)为 97.1%(95%CI:94.6-99.7)。SG 术后卒中发生率为 2.5%(95%CI:1-4.1),EG 为 2.1%(95%CI:0.3-3.8)。总体而言,SG 术后 30 天闭塞率估计为 0.9%(95%CI:0-1.8),EG 为 0.7%(95%CI:0-1.7)。SG 术后 30 天死亡率为 3.4%(95%CI:0.9-5.8),EG 为 0.7%(95%CI:0-1.7)。SG 介入治疗后平均随访时间为 65.5 个月(95%CI:45.5-85.5),EG 为 22.4 个月(95%CI:14.72-30.16)。在随访期间,SG 再狭窄率为 2.8%(95%CI:0.5-5.1),EG 为 16.6%(95%CI:5-28.1)。总之,血管内治疗方法似乎在短期至中期内提供了较好的效果,但在随访期间再狭窄率较高。

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