本研究的目的是研究未覆盖的Ascyrus医用夹层支架(AMDS)用于急性A型主动脉夹层手术治疗后主动脉上血管灌注的变化。
从2017年到2020年,该研究纳入了16例接受AMDS治疗且至少1条主动脉上血管受累(解剖至完全闭塞)的连续患者。基于中心线的真实计算机断层扫描测量,在手术前后使用Terarecon软件进行假腔和总腔面积.真实管腔面积的变化被索引到整个血管面积。使用配对样本t检验来评估所观察到的差异的显著性。
对主动脉上血管和降主动脉的分析显示,植入AMDS后,真腔灌注明显改善。术后真实管腔面积指数增加72%,无名者中的112%和30%,左右颈总动脉,分别。手术治疗后,两条颈总动脉的完全闭塞完全恢复。近端和中降主动脉显示真实管腔面积指数的78%和48%的改善,分别。
使用AMDS的Arch修复在治疗急性A型主动脉夹层中显示出有希望的结果。真实和虚假管腔灌注的定量测量表明,真实管腔面积显着增加,完全闭塞的主动脉上分支消退100%。需要在更大的患者队列中进行进一步检查,并与孤立的半弓修复进行比较,以确认AMDS植入后血管重塑阳性。
The goal of the present study is to investigate changes in supra-aortic vessel perfusion after implantation of the non-covered Ascyrus Medical Dissection Stent (AMDS) for surgical treatment of acute type A aortic dissection.
From 2017 to 2020, 16 consecutive patients treated with AMDS and involvement (dissection to total occlusion) of at least 1 supra-aortic vessel were included in the study. Centre-line based computed tomography measurements of true, false and total lumen area using Terarecon software were performed before and after surgery. Changes in the true lumen area were indexed to the entire vessel area. The paired sample t-test was used to assess the significance of the observed differences.
Analysis of supra-aortic vessels and the descending aorta showed significant improvement in true lumen perfusion after the AMDS was implanted. The indexed true lumen area increased postoperatively by 72%, 112% and 30% in the innominate, right and left common carotid arteries, respectively. Total occlusions of both common carotid arteries recovered completely after surgical treatment. The proximal- and the mid-descending aorta showed a 78% and 48% improvement of the indexed true lumen area, respectively.
Arch repair using AMDS shows promising results in the treatment of acute type A aortic dissection. Quantitative measurements of true and false lumen perfusion demonstrated a significant increase in true lumen area and a 100% regression of totally occluded supra-aortic branches. Further examination in a larger cohort of patients and comparison with isolated hemiarch repair are needed to confirm positive vascular remodelling after an AMDS implant.