摘要
目的对比分析Castor单分支支架及体外开窗支架治疗锚定区不足的胸主动脉疾病的疗效及安全性。方法该研究为回顾性队列研究。回顾性收集郑州大学第一附属医院2017年12月至2021年6月以Castor分支支架或体外开窗支架治疗的胸主动脉疾病患者的临床资料。共纳入患者184例,应用Castor分支支架99例,体外开窗支架85例,收集所有患者的一般临床资料、手术资料、围手术期及随访期临床及影像学资料、术后并发症等。采用χ^(2)检验比较两组并发症发生率,采用Kaplan-Meier法绘制两组术后的无不良事件生存率。结果所有患者均成功植入支架,手术成功率100%。Castor组重建其他分支血管2例,开窗组中双开窗12例。Castor组平均手术时间明显短于开窗组,在局麻下完成手术比例高于开窗组,随访期内漏率明显低于开窗组(P值均<0.05)。两组患者术后住院时间、围手术期并发症发生率、死亡率、神经系统并发症发生率、新发夹层或动脉瘤率、分支支架狭窄率、二次手术干预率、假腔血栓化等情况差异均无统计学意义(P>0.05)。Castor组无不良事件生存率略高于开窗组,但其差异无统计学意义(P>0.05)。结论Castor分支支架与体外开窗支架治疗锚定区不足的主动脉疾病近中期疗效良好,均为重建LSA及其他分支动脉安全有效的选择。
ObjectiveTo compare the efficacy and safety of Castor single-branch stent and in vitro fenestration stent in treating thoracic aortic diseases with insufficient landing zone.MethodsThe clinical data of patients with thoracic aortic diseases treated with Castor single-branch stent or in vitro fenestrated stent between December 2017 and June 2021 in the First Affiliated Hospital of Zhengzhou University were retrospectively analyzed.A total of 184 patients were included,99 patients were treated with Castor branch stent,and 85 patients with in vitro fenestration stent.All patients′general clinical data,surgical data,perioperative and follow-up clinical and imaging data,and postoperative complications were collected.Theχ^(2) test was used to compare the incidence of complications between the two groups,and the Kaplan-Meier method was used to plot the survival rate without adverse events between the two groups.ResultsStent placement was successful in all patients,and the success rate of the technique was 100%.Other branches were reconstructed in 2 patients in the Castor group and double fenestrated stent were reconstructed in 12 patients in the fenestrated group.The mean operation time of the Castor group was significantly shorter than that of the fenestrated group,the number of patients who received local anesthesia was significantly lower than that of the fenestrated group,and the endoleak rate during follow-up was significantly lower than that of the fenestrated group(P<0.05).There was no significant difference in the postoperative hospital stay,the incidence rate of perioperative complications,mortality,the incidence rate of neurological complications,new dissection or aneurysm rate,branch stent stenosis rate,second surgical intervention rate,and false lumen thrombosis between the two groups(P>0.05).The adverse event-free survival rate of the Castor group was slightly higher than that of the fenestrated group,but its difference was not statistically significant(P>0.05).ConclusionCastor branch stent and in vitro
作者
周朋利
王洋
张庆辉
王玲
吴正阳
张文广
韩新巍
Zhou Pengli;Wang Yang;Zhang Qinghui;Wang Ling;Wu Zhengyang;Zhang Wenguang;Han Xinwei(Department of Interventional Radiology,the First Affiliated Hospital,Zhengzhou University,Zhengzhou 450052,China;Department of Interventional Radiology,the First Affiliated Hospital,Henan University of Science and Technology,Luoyang 471023,China)
出处
《中华放射学杂志》
CAS
CSCD
北大核心
2024年第4期422-429,共8页
Chinese Journal of Radiology
基金
河南省高等学校重点科研项目(22A320068)。
关键词
主动脉疾病
胸主动脉腔内修复术
锁骨下动脉
分支支架
开窗支架
Aortic diseases
Thoracicendovascular aortic repair
Subclavain artery
Branched stent-graft
Fenestrated stent-graft
