UNASSIGNED:StanfordB型主动脉夹层(TBAD)是一种罕见的心血管急症,起病迅速,危害很大。目前,尚无相关研究分析急性和非急性期TBAD患者接受腔内修复治疗的临床获益差异.探讨不同手术时机下TBAD患者腔内修复术的临床特点及预后。
UNASSIGNED:回顾性选择2014年6月至2022年6月110例TBAD患者的病历作为研究对象。根据手术时间分为急性组(发病时间≤14天)和非急性组(发病时间>14天),两组在手术和住院方面进行比较,主动脉重塑,和后续结果。采用单因素和多因素logistic回归分析影响TBAD腔内修复预后的因素。
未经证实:胸腔积液的比例,心率,急性组假腔完全血栓形成率及假腔最大直径差异均高于非急性组(P=0.015,<0.001,0.029,<0.001)。住院时间和术后假腔最大直径低于非急性组(P=0.001,0.004)。两组技术成功率无统计学差异,重叠支架长度,重叠支架直径,术后即刻对比剂I型内漏,肾衰竭的发生率,缺血性疾病,内漏,主动脉扩张,逆行A型主动脉缩窄,和死亡(P=0.386,0.551,0.093,0.176,0.223,0.739,0.085,0.098,0.395,0.386);冠状动脉疾病[比值比(OR)=6.630,P=0.012],胸腔积液(OR=5.026,P=0.009),非急性手术(OR=2.899,P=0.037),腹主动脉受累(OR=11.362,P=0.001)是影响TBAD腔内修复术后预后的独立危险因素。
未经证实:TBAD急性期腔内修复可能有助于主动脉重构,TBAD患者的预后可以结合冠心病进行临床评估,胸腔积液,和腹主动脉受累进行早期干预,以降低相关死亡率。
UNASSIGNED: Stanford type B aortic dissection (TBAD) is a rare cardiovascular emergency with rapid onset and great harm. Currently, no relevant studies have analyzed the difference in clinical benefits of endovascular repair in patients with TBAD in acute and non-acute stages. To investigate the clinical characteristics and prognosis of endovascular repair in patients with TBAD at different surgical timing.
UNASSIGNED: The medical records of 110 patients with TBAD from June 2014 to June 2022 were retrospectively selected as the
study subjects. The patients were divided into an acute group (onset time ≤14 days) and a non-acute group (onset time >14 days) according to the time to surgery, and the two groups were compared in terms of surgery and hospitalization, aortic remodeling, and follow-up results. Univariate and multivariate logistic regression were used to analyze the factors affecting the prognosis of TBAD treated with endoluminal repair.
UNASSIGNED: The proportion of pleural effusion, heart rate, the rate of complete thrombosis of the false lumen and the difference in the maximum diameter of the false lumen in the acute group were higher than those in the non-acute group (P=0.015, <0.001, 0.029, <0.001). The length of hospital stay and the maximum postoperative diameter of the false lumen was lower than in the non-acute group (P=0.001, 0.004). There was no statistically significant difference between the two groups in the technical success rate, overlapping stent length, overlapping stent diameter, immediate postoperative contrast type I endoleak, incidence of renal failure, ischemic disease, endoleaks, aortic dilatation, retrograde type A aortic coarctation, and death (P=0.386, 0.551, 0.093, 0.176, 0.223, 0.739, 0.085, 0.098, 0.395, 0.386); coronary artery disease [odds ratio (OR) =6.630, P=0.012], pleural effusion (OR =5.026, P=0.009), non-acute surgery (OR =2.899, P=0.037), and involvement of the abdominal aorta (OR =11.362, P=0.001) were all independent risk factors affecting the prognosis of TBAD treated with endoluminal repair.
UNASSIGNED: Acute phase endoluminal repair of TBAD may contribute to aortic remodeling, and the prognosis of TBAD patients can be assessed clinically in combination with coronary artery disease, pleural effusion, and involvement of the abdominal aorta for early intervention to reduce the associated mortality.