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The Journal of cardiovascular surgery 开放腹主动脉手术后吻合口旁动脉瘤的血管内治疗。

影响因子：1.595 DOI：10.23736/S0021-9509.18.10145-5

作者： Spanos K,Kölbel T,Kouvelos G,Tsilimparis N,Debus SE,Giannoukas AD 发表时间：2020-07-09 12:20:34

from：《JOURNAL OF CARDIOVASCULAR SURGERY》

keywords： Spanos KKölbel TKouvelos GTsilimparis NDebus SEGiannoukas AD

关键词：

Abstract

INTRODUCTION:The repair of long-term complications of open abdominal aortic repair such as para-anastomotic aneurysm (PAA) and pseudoaneurysm (PSA) is very challenging. The aim of this study was to assess the outcomes of endovascular repair of PAA/PSA after previous open aortic surgery for aneurismal or occlusive disease. EVIDENCE ACQUISITION:A systematic review was undertaken; a search was performed (PRISMA) in MEDLINE, CENTRAL, Cochrane databases and key references of all studies of endovascular treatment of PAA/PSA after open aortic surgery. EVIDENCE SYNTHESIS:Eighteen studies included totally 433 patients (86.3% males) with mean age of 71±2.5 years were identified. Most of the patients were asymptomatic (76%) and diagnosed with PAA (60.5%), while 81.6% had history of open aortic reconstruction for aneurismal disease. The mean diameter of para-anastomotic aneurysms was 59.7 mm (from 23 mm to 110 mm) and the mean duration until their diagnosis was 10±2 years. Standard bifurcated (23.7%), fenestrated (23.4%) and aorto-uni-iliac stent-grafts (16.3%) were mostly used. The technical success rate was 97.8% (391/400) with 1.4% (6/433) 30 day-mortality rate and mean hospital stay of 6±3 days. The mean 1- and 2- year survival rate was 87.8% and 78.8%, respectively. The follow-up ranged from 9 to 43 months, with presenting complications such as endoleak type I (24/378; 6.3%), type II (15/354; 4.3%), type III (3/378;0.8%), migration (4/378; 1%) and limb occlusion (5/310;1.6%). Additionally, 5.7% (19/332) of the patients underwent open conversion, while the total re-intervention rate was 11.4% (39/340; time of reintervention ranged from 7 to 30 months). In cases in which a stent was used for splanchnic vessels (renal artery: 188, superior mesenteric artery: 98, celiac artery: 64), the primary patency rate was 97.4% (341/350). CONCLUSIONS:Endovascular treatment of PAAs and PSAs after previous open aortic surgery is a feasible and efficient option with high technical success rate, low 30-day mortality and good mid-term outcomes.

摘要

导读: 开放腹主动脉修复术的远期并发症如吻合口旁动脉瘤 (PAA) 和假性动脉瘤 (PSA) 的修复非常具有挑战性。本研究的目的是评估既往主动脉开放手术后PAA/PSA腔内修复术治疗动脉瘤或闭塞性疾病的结局。证据获取: 进行了系统评价; 在MEDLINE、CENTRAL、cochrane数据库和主动脉开放术后PAA/PSA腔内治疗所有研究的关键参考文献。证据综合: 18 项研究共纳入 433 例患者 (86.3% 例男性)，平均年龄 71 ± 2.5 岁。大多数患者无症状 (76%)，诊断为PAA (60.5%)，而 81.6% 有动脉瘤性疾病的开放主动脉重建史。吻合口旁动脉瘤的平均直径为 59.7毫米 (从 23毫米到 110毫米)，平均持续时间至诊断为 10 ± 2 年。主要使用标准分叉 (23.7%) 、开窗 (23.4%) 和主-单髂骨支架 (16.3%)。技术成功率 97.8% (391/400)，1.4% (6/433) 30 天-死亡率，平均住院时间 6 ± 3 天。平均 1 年和 2 年生存率分别为 87.8% 和 78.8%。随访 9 ~ 43 个月，主要并发症为内漏 ⅰ 型 (24/378; 6.3%) 、 ⅱ 型 (15/354; 4.3%) 、 ⅲ 型 (3/378;0.8%) 、迁移 (4/378; 1%) 和肢体闭塞 (5/310;1.6%)。此外，5.7% (19/332) 的患者接受了开放转换，而总再干预率为 11.4% (39/340; 再干预时间为 7 ~ 30 个月)。在内脏血管支架 (肾动脉: 188，肠系膜上动脉: 98，腹腔动脉: 64) 的病例中，一期通畅率为 97.4% (341/350)。结论: 既往主动脉开放手术后PAAs和PSAs的腔内治疗是一种可行而有效的选择，技术成功率高，30 天死亡率低，中期预后良好。

期刊介绍

《JOURNAL OF CARDIOVASCULAR SURGERY》 (点击进入期刊详情)

英文简介 : A Journal on the Diagnosis and Therapy of Cardiac Thoracic and Vascular Diseases. Frequency: Bi-Monthly. Affiliated with the Society of Cardio-Thoracic Surgeons.

中文简介 : （来自Google、百度翻译）心胸血管疾病的诊断和治疗杂志。频率：双月。隶属于心胸外科医师协会。

CIRCULATION RESEARCH 期刊中科院评价数据

新中科院分区

大类(学科)	小类(学科)	学科排名
医学	CARDIAC & CARDIOVASCULAR SYSTEMS (心脏和心血管系统) PERIPHERAL VASCULAR DISEASE (外周血管病) SURGERY (外科)	110/128 59/65 145/200

大类(学科)

小类(学科)

学科排名

医学

CARDIAC & CARDIOVASCULAR SYSTEMS (心脏和心血管系统)

PERIPHERAL VASCULAR DISEASE (外周血管病)

SURGERY (外科)

110/128
59/65
145/200

新发布的期刊年发文量