Incidence and Survival Outcome Following Femoral Artery Reconstruction During Endovascular Abdominal Aortic Aneurysm Repair
Incidence and Survival Outcome Following Femoral Artery Reconstruction During Endovascular Abdominal Aortic Aneurysm Repair
复制标题
腹主动脉瘤腔内修复术中股动脉重建后的发病率和生存结果
DOI：
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发表时间：
2011
影响因子：
0.9
通讯作者：
I. Williams
中科院分区：
文献类型：
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作者：
C. Twine;A. Wood;A. Gordon;S. Hill;R. Whiston;I. Williams
背景：在血管内腹主动脉瘤修复（EVAR）支架植入术后，可能需要计划或不计划地重建股总动脉（股股交叉和/或补片闭合），以关闭动脉或维持肢体灌注。本研究的目的是检查EVAR后股骨总动脉重建（FAR）的发生率，并检查其对患者生存的影响。方法：回顾性分析178例行EVAR的患者。结果：31例（17.4%）患者行FAR；股股交叉16例（51.6%），动脉内膜切除术和补片闭合15例（48.4%）。FAR患者的全因生存率明显低于直接缝合患者（P = 0.010）。在前瞻性条件分析中，共有3个因素：FAR的需要（风险比[HR] = 0.435, P = 0.006）、慢性阻塞性肺疾病（[COPD] HR = 0.424, P = 0.002）和腹主动脉瘤（AAA）大小（HR = 1.414, P = 0.005）与生存率有显著且独立的相关性。结论：近五分之一的EVAR患者进行了股动脉重建，并降低了生存率。多学科团队在计划EVAR时应注意这些发现，特别是在边缘候选人中。
Background: Planned or unplanned reconstruction of the common femoral artery (femoro-femoral crossover and/or patch closure) may be required following endovascular abdominal aortic aneurysm repair (EVAR) stent graft deployment for arterial closure or maintenance of limb perfusion. The aim of this study was to examine the incidence of common femoral artery reconstruction (FAR) following EVAR and examine the effect on patient survival. Methods: A total of 178 patients undergoing EVAR were studied retrospectively. Results: In all, 31 patients (17.4%) underwent FAR; 16 (51.6%) femoro-femoral crossover, and 15 (48.4%) endarterectomy and patch closure. All cause survival in patients undergoing FAR was significantly poorer than those undergoing direct closure (P = .010).A total of 3 factors: the need for FAR (hazard ratio [HR] = 0.435, P = .006), chronic obstructive pulmonary disease ([COPD] HR = 0.424, P = .002), and abdominal aortic aneurysm (AAA) size (HR = 1.414, P = .005) were significantly and independently associated with survival on forward conditional analysis. Conclusions: Femoral artery reconstruction was performed in almost 1 in 5 patients undergoing EVAR and associated with decreased survival. Multidisciplinary teams should be aware of these findings when planning EVAR, especially in borderline candidates.