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国际接力研究,分支结果——旨在修复胸主动脉:双分支与三分支构型的比较分析

International RELAY, branched outcomes - designed to respect and repair the thoracic aorta: A comparative analysis between double and triple branched configurations.

作者信息

Singh Sidhant, Surkhi Abedalaziz O, Howard Callum, Mariscalco Giovanni

机构信息

Barts and The London School of Medicine and Dentistry, Queen Mary University of London, UK.

Faculty of Medicine, Al Quds University, Jerusalem, Palestine.

出版信息

Asian Cardiovasc Thorac Ann. 2023 Sep;31(7):624-632. doi: 10.1177/02184923231160697. Epub 2023 Jun 4.

Abstract

BACKGROUND

Endovascular aortic arch repair (EAR) has emerged as an alternative to open surgical repair. A growing interest in endovascular repair techniques for aortic arch aneurysms and dissection has been met with a focus on the clinical efficacy of EAR devices. We present multicentre comparative data on the clinical outcomes associated with EAR using the double- and triple-branched configurations of the RELAY™ (Terumo Aortic, Scotland, UK) endograft.

METHODS

Multicentre data on EAR procedures, carried out from January 2019 to January 2022, using the double- and triple-branched RELAY™ endograft were collected prospectively. Follow-up data were collected at 30 days, 6 months, 12 months, and 24 months postoperative. Retrospective descriptive analysis, logistic regression, and Kaplan-Meier analysis were carried out on procedural and follow-up data.

RESULTS

A total of 131 patients were included in the series. In total, 103 and 28 patients were treated with the double-branched and triple-branched RELAY™ endograft, respectively. Over the 24-month follow-up period, zero mortality, cases of stroke, or reinterventions were recorded in the triple-branched group. Four mortalities, 19 disabling strokes, and 50 reinterventions were recorded in the double-branched group within 30 postoperative days. Target vessel patency was maintained in all patients in the triple-branched group, while vessel patency was maintained in 74.0% of patients in the double-branched group.

CONCLUSION

Outcomes associated with the triple-branched group are consistent with those reported in the literature. Our data suggest that EAR with the RELAY™ endograft is associated with favourable clinical outcomes and clinical efficacy. Further comparative research into EAR devices is needed.

摘要

背景

血管腔内主动脉弓修复术(EAR)已成为开放性手术修复的替代方案。人们对主动脉弓动脉瘤和夹层的血管腔内修复技术兴趣日增,同时也关注EAR装置的临床疗效。我们展示了使用RELAY™(泰尔茂主动脉,英国苏格兰)腔内血管移植物的双分支和三分支构型进行EAR的多中心比较数据。

方法

前瞻性收集2019年1月至2022年1月使用双分支和三分支RELAY™腔内血管移植物进行EAR手术的多中心数据。术后30天、6个月、12个月和24个月收集随访数据。对手术和随访数据进行回顾性描述分析、逻辑回归分析和Kaplan-Meier分析。

结果

该系列共纳入131例患者。其中,分别有103例和28例患者接受了双分支和三分支RELAY™腔内血管移植物治疗。在24个月的随访期内,三分支组未记录到死亡、中风或再次干预病例。双分支组在术后30天内记录到4例死亡、19例致残性中风和50例再次干预。三分支组所有患者的目标血管通畅得以维持,而双分支组74.0%的患者血管通畅得以维持。

结论

三分支组的结果与文献报道一致。我们的数据表明,使用RELAY™腔内血管移植物进行EAR具有良好的临床结果和临床疗效。需要对EAR装置进行进一步的比较研究。

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