Comparison of access type on perioperative outcomes after endovascular aortic aneurysm repair
Comparison of access type on perioperative outcomes after endovascular aortic aneurysm repair
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DOI：
10.1016/j.jvs.2017.10.075
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发表时间：
2018-07-01
影响因子：
4.3
通讯作者：
Schermerhorn, Marc L.
中科院分区：
文献类型：
--
作者：
Siracuse, Jeffrey J.;Farber, Alik;Schermerhorn, Marc L.
目的：腹主动脉瘤腔内修复术（EVAR）可以通过经皮或手术入路进行。我们的目标是评估基于真实环境中入路类型的围手术期结局差异。方法：查询血管质量倡议（VQI）数据库进行EVAR。使用单变量分析和多变量分析确定入路类型的独立影响。结果：分别有8340例（64%）和4747例（36%）腹主动脉瘤腔内修复术通过经皮和手术入路进行（3395例[72%]横向切口和1352例[28%]垂直切口）347例（4%）经皮穿刺失败经皮穿刺更多见于年轻男性、体重指数较高的患者，多变量分析显示，与经皮穿刺入路相比，手术横向入路与更多的心脏并发症相关（比值比，1.53，95%置信区间[CI]，1.14-2.05，P = .005），手术时间延长（平均比值比[MR]，1.25，95% CI，1.23-1.27，P = .005），
Objective: Endovascular aneurysm repair (EVAR) can be performed through percutaneous or surgical access Our goal was to assess the difference in perioperative outcomes based on access type in a real-world setting.Methods: The Vascular Quality Initiative (VQI) database was queried for EVAR Univariable analysis and multivariable analysis were used to determine the independent effect of access type.Results: There were 8340 (64%) and 4747 (36%) EVAR procedures performed through percutaneous and surgical access (3395 [72%] transverse and 1352 [28%] vertical incisions) In 347 cases (4%), percutaneous access failed Percutaneous access was performed more in patients who were younger and male, had higher body mass index, were nonsmokers, and had commercial insurance Multivariable analysis showed that surgical transverse compared with percutaneous access was associated with more cardiac complications (odds ratio, 1 53, 95% confidence interval [CI], 1.14-2.05, P = .005), prolonged operative time (means ratio [MR], 1.25, 95% CI, 1.23-1.27, P