目的:进行系统评价,以评估支架移植物(SGs)血管内治疗与持续性坐骨动脉(PSA)相关的并发症的安全性和有效性。
方法:MEDLINE,WebofScience,Scopus,检索和IchushiWeb数据库,以确定从开始到2023年9月15日发表的关于SGs血管内治疗与PSA相关的并发症的文章.审查包括31例病例报告,2个案例系列,和7个会议记录。40名患者(中位年龄:67岁,范围:22-88岁;25名妇女)41条肢体接受了65SGs缺血的血管内治疗(n=26),动脉瘤(n=13),和创伤(n=2)。先前的治疗是全身抗凝(n=7),溶栓(n=5),血栓切除术(n=3),截肢(n=1),同时治疗是溶栓(n=6)和血栓切除术(n=2)。植入SGs的中位数为2(范围:1-4)。早期结果是技术成功和并发症。晚期结果是原发性通畅,二级通畅,免于重新干预,和临床成功。
结果:技术成功率为100%。4例报告了干预性并发症,但没有发生重大不良事件.1年和2年的临床成功率分别为100%和95.7%,分别。1年和2年的主要通畅率分别为81.5%和67.6%,分别,1年和2年的二次通畅率分别为94.5%和81.6%,分别。
结论:SGs血管内治疗PSA相关并发症是安全有效的,具有可接受的中期通畅性和耐用性,并被推荐为首选治疗。
OBJECTIVE: To evaluate the safety and effectiveness of endovascular therapy with stent grafts (SGs) to treat complications associated with persistent sciatic artery (PSA) by conducting a systematic review.
METHODS: The MEDLINE, Web of Science, Scopus, and Ichushi Web databases were searched to identify articles focusing on endovascular treatment with SGs for complications associated with PSA published from inception to September 15, 2023. The review included 31 case reports, 2 case series, and 7 conference proceedings. Forty patients (median age, 67 years [range, 22-88 years]; 25 women) with 41 limbs underwent endovascular treatment with 65 SGs for ischemia (n = 26), aneurysm (n = 13), and trauma (n = 2). Prior treatments were systemic anticoagulation (n = 7), thrombolysis (n = 5), thrombectomy (n = 3), and amputation (n = 1), whereas concurrent treatments were thrombolysis (n = 6) and thrombectomy (n = 2). The median number of SGs implanted was 2 (range, 1-4). Early outcomes were technical success and adverse events (AEs). Late outcomes were primary patency, secondary patency, freedom from reintervention, and clinical success.
RESULTS: The technical success rate was 100%. Intervention-specific AEs were reported in 4 cases; however, there were no severe AEs. The clinical success rates at 1 and 2 years were 100% and 95.7%, respectively. The primary patency rates at 1 and 2 years were 81.5% and 67.6%, respectively, and the secondary patency rates at 1 and 2 years were 94.5% and 81.6%, respectively.
CONCLUSIONS: Endovascular treatment with SGs for complications associated with PSA is safe and effective with acceptable midterm patency and durability, and is supportable as the first-choice treatment.