■本研究旨在评估经胸主动脉腔内修复术(TEVAR)治疗的钝性胸主动脉损伤(BTAI)患者的长期预后。
■从2010年1月至2019年12月,这项回顾性观察研究在3个中心进行,涉及62例接受TEVAR的连续BTAI患者。计划在术后6个月进行计算机断层扫描血管造影扫描,此后每年。
■在所有62个程序(100%)中都取得了技术成功,其中包括夹层病例(n=35,56.45%),假性动脉瘤(n=20,32.26%),和破裂(n=7,11.29%)。平均损伤严重程度评分为31.66±8.30。通过烟囱技术对21个弓上分支进行了血运重建,其中累及左锁骨下动脉(LSA)12例,累及左颈总动脉9例。此外,在手术过程中涵盖了11个LSA。住院死亡率为1.61%(n=1)。平均随访时间为86.82±30.58个月。全因随访死亡率为3.28%(n=2)。随访发现3个弓上分支狭窄或闭塞(4.92%),2例(3.28%)需要再次干预。无脊髓缺血,内漏,或观察到迁移。
■尽管只包括长期随访的患者,本研究证实了TEVAR治疗BTAI的长期安全性和有效性.对于年轻的BTAI患者,随着年龄的增长胸主动脉,需要更长的随访时间来观察移植物与主动脉之间的潜在错配.
结论:这项研究证实了腔内治疗钝性胸主动脉损伤(BTAI)的长期安全性和有效性。对于年轻的BTAI患者,随着年龄的增长胸主动脉,需要更长的随访时间来观察移植物与主动脉之间的潜在错配.通过在中国多个中心进行的显著延长的随访期(86.82±30.58个月),本研究证实了血管内治疗BTAI的长期安全性和有效性.
UNASSIGNED: This study aimed to assess the long-term outcomes in patients treated by thoracic endovascular aortic repair (TEVAR) for blunt thoracic aortic injuries (BTAI).
UNASSIGNED: From January 2010 to December 2019, this retrospective observational study was conducted at 3 centers, involving 62 consecutive BTAI patients who underwent TEVAR. Computed tomography angiography scans were planned to be conducted at 6 months post-procedure, and annually thereafter.
UNASSIGNED: Technical success was achieved in all 62 procedures (100%), which included cases of dissection (n=35, 56.45%), pseudoaneurysm (n=20, 32.26%), and rupture (n=7, 11.29%). Mean injury severity score was 31.66±8.30. A total of 21 supra-arch branches were revascularized by chimney technique, with 12 cases involving the left subclavian artery (LSA) and 9 cases involving the left common carotid artery. In addition, 11 LSAs were covered during the procedure. The in-hospital mortality rate was 1.61% (n=1). The mean follow-up time was 86.82±30.58 months. The all-cause follow-up mortality rate was 3.28% (n=2). Stenosis or occlusion of 3 supra-arch branches (4.92%) was identified at follow-up, with 2 cases (3.28%) requiring re-intervention. No spinal cord ischemia, endoleak, or migration was observed.
UNASSIGNED: Despite only including patients with long-term follow-up, this study confirms the long-term safety and effectiveness of TEVAR for BTAI. For young BTAI patients, as the thoracic aorta increases with age, longer follow-up is needed to observe the potential mismatch between the endograft and the aorta.
CONCLUSIONS: This study confirms the long-term safety and effectiveness of endovascular treatment for blunt thoracic aortic injury (BTAI). For young BTAI patients, as the thoracic aorta increases with age, longer follow-up is needed to observe the potential mismatch between the endograft and the aorta. Through a remarkably extended follow-up period (86.82±30.58 months) conducted at multiple centers in China, this study confirms the long-term safety and effectiveness of endovascular treatment for BTAI.