Potential risk factors of re-intervention after endovascular repair for type B aortic dissections
Potential risk factors of re-intervention after endovascular repair for type B aortic dissections
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B型主动脉夹层腔内修复术后再次干预的潜在危险因素
DOI：
10.1002/ccd.25733
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发表时间：
2015-07-01
影响因子：
2.3
通讯作者：
Jing, Zaiping
中科院分区：
文献类型：
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作者：
Zhang, Lei;Zhou, Jian;Jing, Zaiping
目的评估胸主动脉腔内修复术 (TEVAR) 后再次干预的潜在危险因素。背景TEVAR 已被选为 B 型主动脉夹层 (TBAD) 的侵入性较小的替代方案；然而，重新干预的潜在风险因素仍不清楚。方法：回顾性分析1998年9月至2012年7月期间首次接受TEVAR治疗的252例TBADs患者。初始 TEVAR 的适应症为 32 例主动脉扩大（24 例慢性）、71 例灌注不良、46 例破裂（32 例慢性）、67 例难治性疼痛（54 例慢性）和 44 例难治性高血压（38 例慢性）。将患者分为单项干预组和多项干预组。结果平均年龄54.1岁，其中男性占81.7%。我们发现多重干预组从症状出现到 TEVAR 的时间更长（17 天 vs. 112.5 天，P=0.006）。多干预组中慢性夹层和吸烟的比例较高（分别为53.9% vs. 79.2%和43.9% vs. 70.8%，P=0.018和0.012）。各组间尺寸过大、手术时间、造影剂剂量和失血量差异显着（13.82.4% vs. 16.4+/-2.9%、92.5 min vs. 196 min、110 vs. 210 ml、100 vs. 300 ml；P
ObjectivesTo assess the potential risk factors of re-intervention after thoracic endovascular aortic repair (TEVAR).BackgroundTEVAR has been chosen as a less invasive alternative for Type B aortic dissections (TBADs); however, the potential risk factors of re-intervention remain unclear. Methods: A total of 252 TBADs patients initially treated with TEVAR between September 1998 and July 2012 were retrospectively reviewed. The indications for the initial TEVAR were 32 aorta enlargement (24 chronic), 71 malperfusion, 46 rupture (32 chronic), 67 refractory pain (54 chronic), and 44 refractory hypertension (38 chronic). The patients were stratified into single-intervention group and multi-intervention group.ResultsThe mean age was 54.1 years with 81.7% of male. We found the time from symptom onset to TEVAR was longer in multi-intervention group (17 vs. 112.5 days, P=0.006). Higher proportions of chronic dissection and smoking occurred in multi-intervention group (53.9% vs. 79.2% and 43.9% vs. 70.8%, P=0.018 and 0.012, respectively). The differences of oversizing, operation time, contrast medium dose, and blood loss between the groups were significant (13.82.4% vs. 16.4 +/- 2.9%, 92.5 vs. 196 minutes, 110 vs. 210 ml, 100 vs. 300 ml; P