实用临床医药杂志2024，Vol.28Issue(22)：1-7,15,8.DOI:10.7619/jcmp.20243702
复杂胸腹主动脉疾病行开窗或分支支架技术治疗后并发症的危险因素分析
Risk factors of occurrence of complications after fenestrated or branched endovascular aortic repair for complex thoracoabdominal aortic diseases
摘要
Abstract
Objective To analyze the risk factors of occurrence of complications after fenestrated or branched endovascular aortic repair(F/B-EVAR)for complex thoracoabdominal aortic diseases.Meth-ods Clinical materials of 147 patients with F/B-EVAR for thoracoabdominal aortic diseases in the Department of Vascular Surgery of Drum Tower Hospital Affiliated to Medical College of Nanjing Uni-versity from 2021 to 2023 were retrospectively analyzed.Multivariate correlation analysis was used to explore the risk factors for postoperative complications during the mid-term follow-up.Results There were 13 postoperative deaths,with a mortality rate of 8.8％;52 patients experienced overall surgery-related complications,with an incidence rate of 35.4％;31 patients had postoperative endoleaks,with an endoleak rate of 21.1％;14 patients had branch stent-related endoleaks,involving 14 bran-ches;and 4 patients had branch occlusion,involving 5 branches.The re-intervention rate in this study was 20.4％(30/147),with 20 cases(13.6％)of postoperative renal insufficiency and 1 case of postoperative paraplegia due to spinal cord ischemia,as well as 1 case of postoperative stent infec-tion.Risk factor analysis for postoperative mortality,overall complications,endoleaks,and postoper-ative renal failure was conducted,and the risk factors for overall complications included preoperative renal insufficiency,aortic disease,aortic tortuosity angle＞60 °,and average number of branch re-constructions.The independent influencing factors for postoperative endoleaks included gender,age,history of renal insufficiency,history of thoracic endovascular aortic repair(TEVAR),aortic tortuosity angle＞60°,and true lumen diameter in thoracoabdominal aortic dissection(TAAD).The inde-pendent influencing factor for postoperative renal failure was preoperative renal insufficiency.Con-clusion Female,age,thoracoabdominal aortic aneurysm(TAAA),history of renal insufficiency,history of TEVAR,aortic tortuosity angle＞60°,and true lumen diameter in TAAD are the influen-cing factors for postoperative complications in patients with thoracoabdominal aortic diseases,and the possible related factors are TAAA sac diameter and TAAD false lumen diameter.关键词
胸腹主动脉疾病/开窗或分支支架技术/并发症/胸主动脉腔内修复术/自制支架/内漏Key words
thoracoabdominal aortic diseases/fenestrated or branched endovascular aortic repair/complications/thoracic endovascular aortic repair/custom-made stent/endoleak分类
医药卫生引用本文复制引用
周艳,邹佳佳,刘昭,李晓强,翁艳敏..复杂胸腹主动脉疾病行开窗或分支支架技术治疗后并发症的危险因素分析[J].实用临床医药杂志,2024,28(22):1-7,15,8.基金项目
国家自然科学基金资助项目(82100527) （82100527）
