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腔内修复术后晚期腹主动脉瘤破裂：一项荟萃分析研究

Late post-EVAR abdominal aortic aneurysm rupture: a meta-analysis study.

作者信息

Papadoulas Spyros, Pitros Christos, Tsimpoukis Andreas, Papageorgopoulou Chrysanthi, Prentza Sofia, Leivaditis Vasileios, Antzoulas Andreas, Mulita Francesk, Moulakakis Konstantinos G

机构信息

Department of Vascular Surgery, General University Hospital of Patras, Patras, Greece.

Department of Surgery, General University Hospital of Patras, Greece.

出版信息

Arch Med Sci Atheroscler Dis. 2024 Jul 26;9:e152-e164. doi: 10.5114/amsad/190421. eCollection 2024.

DOI:10.5114/amsad/190421
PMID:39559174
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11571202/
Abstract

This study presents updated information on post-endovascular aneurysm repair (EVAR) late aortic rupture (LAR) as the data in the literature are limited. It comprises a meta-analysis based on the recent evidence regarding the incidence, causes, treatment outcomes, and prognosis of post-EVAR. A meta-analysis was conducted according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Studies were identified by searching electronic databases and scanning bibliographic references from 1991 to April 1, 2023. Our analysis provided evidence that the most common causes of rupture after EVAR were type Ia and Ib Endoleaks (Els). Post-rupture mortality after EVAR was high (35.6%) and comparable to the morbidity of ruptures. Endovascular repair appears to have better results compared to conversion to open repair. A significant number of patients had prior endovascular reoperations and inadequate follow-up. Patient compliance with the surveillance protocol is mandatory.

摘要

本研究提供了血管内动脉瘤修复术（EVAR）后晚期主动脉破裂（LAR）的最新信息，因为文献中的数据有限。它包括一项基于近期有关EVAR后发病率、病因、治疗结果和预后证据的荟萃分析。根据PRISMA（系统评价和荟萃分析的首选报告项目）指南进行了荟萃分析。通过检索电子数据库和扫描1991年至2023年4月1日的参考文献来识别研究。我们的分析表明，EVAR后破裂的最常见原因是Ia型和Ib型内漏（Els）。EVAR后破裂后的死亡率很高（35.6%），与破裂的发病率相当。与转为开放修复相比，血管内修复似乎有更好的结果。相当数量的患者曾接受过血管内再次手术且随访不足。患者必须遵守监测方案。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b62c/11571202/af9f0e2b4bdc/AMS-AD-9-190421-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b62c/11571202/927aaea16fc0/AMS-AD-9-190421-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b62c/11571202/5a06bde8db5f/AMS-AD-9-190421-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b62c/11571202/f7a4ca8c5165/AMS-AD-9-190421-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b62c/11571202/af9f0e2b4bdc/AMS-AD-9-190421-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b62c/11571202/927aaea16fc0/AMS-AD-9-190421-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b62c/11571202/5a06bde8db5f/AMS-AD-9-190421-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b62c/11571202/f7a4ca8c5165/AMS-AD-9-190421-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b62c/11571202/af9f0e2b4bdc/AMS-AD-9-190421-g004.jpg

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本文引用的文献

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A Greek Multicentre Study Assessing the Outcome of Late Rupture After Endovascular Abdominal Aortic Aneurysm Repair.希腊多中心研究评估血管内腹主动脉瘤修复后迟发性破裂的结果。
Eur J Vasc Endovasc Surg. 2024 May;67(5):756-764. doi: 10.1016/j.ejvs.2023.12.025. Epub 2023 Dec 26.
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Use of linked registry claims data for long term surveillance of devices after endovascular abdominal aortic aneurysm repair: observational surveillance study.使用基于注册登记的索赔数据进行血管内腹主动脉瘤修复术后器械的长期随访：观察性随访研究。
BMJ. 2022 Oct 25;379:e071452. doi: 10.1136/bmj-2022-071452.
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Clinical presentation, operative management, and long-term outcomes of rupture after previous abdominal aortic aneurysm repair.
既往腹主动脉瘤修复术后破裂的临床表现、手术治疗及长期预后
J Vasc Surg. 2023 Feb;77(2):396-405.e7. doi: 10.1016/j.jvs.2022.08.005. Epub 2022 Oct 19.
4
Primary Endovascular Treatment of Late-Onset Type 3 Endovascular Aortic Repair Rupture Using The Endurant II Stent Graft and Rapid Response Protocol.使用Endurant II覆膜支架移植物和快速反应方案对迟发性3型血管腔内主动脉修复术破裂进行初次血管腔内治疗。
Turk Kardiyol Dern Ars. 2022 Dec;50(8):613-616. doi: 10.5543/tkda.2022.22334.
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Editor's Choice - Structured Computed Tomography Analysis can Identify the Majority of Patients at Risk of Post-Endovascular Aortic Repair Rupture.编辑精选 - 结构化计算机断层扫描分析可识别大多数存在血管内修复后破裂风险的患者。
Eur J Vasc Endovasc Surg. 2022 Aug-Sep;64(2-3):166-174. doi: 10.1016/j.ejvs.2022.04.042. Epub 2022 May 11.
6
Long-term Outcomes Associated With Open vs Endovascular Abdominal Aortic Aneurysm Repair in a Medicare-Matched Database.在 Medicare 匹配数据库中，与开放手术和血管内修复腹主动脉瘤相关的长期结果。
JAMA Netw Open. 2022 May 2;5(5):e2212081. doi: 10.1001/jamanetworkopen.2022.12081.
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