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中国行开放手术或血管腔内手术的大动脉炎患者的临床特征

Clinical Characteristics of Patients with Takayasu Arteritis Undergoing Open or Endovascular Operations in China.

作者信息

Zhang Xihao, Gui Liang, Li Ruihao, Wu Zhiyuan, Chen Zuoguan, Diao Yongpeng, Miao Yuqing, Li Yongjun

机构信息

Department of Vascular Surgery, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, 100005 Beijing, China.

Peking University Fifth School of Clinical Medicine, 100005 Beijing, China.

出版信息

Rev Cardiovasc Med. 2024 Oct 22;25(10):373. doi: 10.31083/j.rcm2510373. eCollection 2024 Oct.

Abstract

BACKGROUND

The operation rate for different involved arteries and the manifestation of vessel involvement of patients with Takayasu arteritis undergoing open or endovascular operations remain unclear. We aimed to investigate the clinical characteristics, vessel involvement, angiographic classification and operations information in a large cohort of patients with Takayasu arteritis undergoing open or endovascular operations at a single centre in China.

METHODS

From January 2017 to October 2022, a total of 153 consecutive patients undergoing open or endovascular operations were recruited from the Department of Vascular Surgery of Beijing Hospital. The demographic characteristics, clinical presentations, pattern of vascular involvement and operation information were collected and analysed.

RESULTS

The majority of patients were female (128/153, 83.7%). The most common vascular finding was hypertension (66.7%). The subclavian (74.2%), carotid (70.1%) and renal (68.9%) arteries were the most commonly involved arteries. Type V (40.5%) was the most common angiographic classification pattern. A total of 296 open or endovascular operations were performed, including 73 percutaneous transluminal angioplasties (PTAs), 50 stent placements and 173 bypass graft operations. Patients with renal (83.3%) or carotid (65.2%) artery involvement had markedly higher rates of undergoing operations.

CONCLUSIONS

The subclavian and carotid arteries, as well as the type V (40.5%) pattern, exhibited the highest frequency of involvement among patients with Takayasu arteritis who underwent open or endovascular operations. Variations in angiographic features can result in differences in clinical manifestations and significantly impact the possibility and modality of operations.

摘要

背景

对于接受开放手术或血管腔内手术的大动脉炎患者,不同受累动脉的手术率以及血管受累表现仍不明确。我们旨在调查在中国一家单中心接受开放手术或血管腔内手术的一大群大动脉炎患者的临床特征、血管受累情况、血管造影分类及手术信息。

方法

2017年1月至2022年10月,从北京医院血管外科连续招募了153例接受开放手术或血管腔内手术的患者。收集并分析了人口统计学特征、临床表现、血管受累模式及手术信息。

结果

大多数患者为女性(128/153,83.7%)。最常见的血管表现是高血压(66.7%)。锁骨下动脉(74.2%)、颈动脉(70.1%)和肾动脉(68.9%)是最常受累的动脉。V型(40.5%)是最常见的血管造影分类模式。共进行了296例开放手术或血管腔内手术,包括73例经皮腔内血管成形术(PTA)、50例支架置入术和173例旁路移植术。肾动脉(83.3%)或颈动脉(65.2%)受累的患者接受手术的比例明显更高。

结论

在接受开放手术或血管腔内手术的大动脉炎患者中,锁骨下动脉和颈动脉以及V型(40.5%)模式的受累频率最高。血管造影特征的差异可导致临床表现的不同,并显著影响手术的可能性和方式。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9cd8/11522748/551e308af460/2153-8174-25-10-373-g1.jpg

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