孤立性腹主动脉夹层腔内治疗及预后分析

邹凌威; 刘浩; 蒋小浪; 刘轶凡; 陈斌; 蒋俊豪; 石赟; 马韬; 林长泼; 董智慧; 符伟国

doi:10.12025/j.issn.1008-6358.2022.20211123

孤立性腹主动脉夹层腔内治疗及预后分析

Efficacy of endovascular treatment for isolated abdominal aortic dissection

摘要

摘要:
目的探讨主动脉腔内修复术（endovascular aorta repair，EVAR）治疗孤立性腹主动脉夹层（isolated abdominal aortic dissection，IAAD）的临床效果。
方法回顾性分析2011年1月至2021年1月在复旦大学附属中山医院血管外科接受EVAR治疗的53例IAAD患者的临床资料，随访术后生存、并发症及二次干预情况等。用SPSS统计软件进行统计描述，应用Kaplan-Meier法计算累计生存率和免于二次干预率。
结果 53例患者均成功接受EVAR治疗，其中1例术后因心包积液死亡，围手术期死亡率为1.9%。52例获得随访，平均随访（54.9±38.9）个月。随访期内死亡3例，无IAAD相关死亡。1、3、5和10年累计生存率为98.1%、98.1%、91.4%、87.1%，免于IAAD病死率均为98.1%，免于二次干预率均为91.9%。
结论 EVAR治疗IAAD具有良好的安全性、有效性，远期疗效较为理想。

Abstract:
Objective To investigate the efficacy of endovascular aorta repair (EVAR) on isolated abdominal aortic dissection (IAAD).
Methods Clinical data of 53 patients with IAAD who received EVAR in the Department of Vascular Surgery, Zhongshan Hospital, Fudan University from January 2011 to January 2021 were retrospectively analyzed. The survival, complication, and reintervention rates were recorded through postoperative follow-up. SPSS was used for statistical description, and the Kaplan-Meier method was used to calculate cumulative survival rate and freedom from reintervention rate.
Results EVAR was successfully performed in all 53 cases. The perioperative mortality rate was 1.9% (1/53). 52 patients were followed up, and the mean follow-up time was (54.9±38.9) months. During the follow-up period, there were 3 all-cause deaths and no IAAD-related death occurred. The overall cumulative survival rates of 1-, 3-, 5-, and 10-year were 98.1%, 98.1%, 91.4%, and 87.1%, respectively, and freedom from IAAD-related mortality rates were all 98.1%, and freedom from reintervention rates were all 91.9%.
Conclusion EVAR has good safety, efficacy, and long-term efficacy for IAAD.

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