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首页> 外文期刊>Journal of cardiac surgery. >Secondary interventions after endovascular thoracic aortic repair
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Secondary interventions after endovascular thoracic aortic repair

机译：血管内胸主动脉修复后的二级干预

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Background Endovascular stent grafting of the descending thoracic aorta has evolved rapidly and is now the standard of care for certain patient subsets. However, the durability of this technique is limited by the development of technique-specific complications at mid-term follow-up. The aim of this study was to evaluate the incidence, techniques, and outcomes of secondary intervention for complications after stent grafting of the descending thoracic aorta. Methods Between March 2001 and November 2011, 152 patients underwent endovascular thoracic aortic repair (TEVAR). We identified 19 (12.5%) patients from this cohort who required secondary interventions. Results The indications for TEVAR were type B aortic dissection in 12 patients, thoracic aortic aneurysm in six patients, and intramural hematoma in one patient. The mean time between TEVAR and secondary intervention was 20.49 ± 24.90 months (range, 1.2-83 months). A secondary endovascular intervention was required in eleven patient, six patients required secondary surgical therapy, and hybrid procedures were performed in two patients. Endoleaks were the most common indication for a secondary intervention. The 30-day mortality rate was 10.5% (2/19). Two perioperative deaths were observed following surgical therapy. During the mean follow-up of 78.06 ± 37.37 months (range, 23-142 months) after TEVAR, four unrelated deaths occurred, two patients were lost to follow-up, and four patients required a further intervention. Conclusions Secondary intervention after endovascular stent grafting of the descending thoracic aorta was not infrequently required and can be performed with acceptable risks. However, serial, systematic follow-up is essential to detect late complications and to perform secondary procedures, preferably under elective circumstances.
机译：背景技术降主动脉的血管内支架移植术发展迅速，现在已成为某些患者亚组的护理标准。但是，该技术的持久性受到中期随访中特定技术并发症的发展的限制。这项研究的目的是评估降主动脉支架移植后并发症的发生率，技术和结果。方法2001年3月至2011年11月，对152例患者进行了腔内胸主动脉修复（TEVAR）。我们从该队列中确定了19名（12.5％）需要二次干预的患者。结果TEVAR的适应症包括12例B型主动脉夹层，6例胸主动脉瘤和1例壁内血肿。 TEVAR和二次干预之间的平均时间为20.49±24.90个月（范围1.2-83个月）。十一名患者需要进行二次血管内干预，六名患者需要进行二次外科手术治疗，两名患者进行了混合手术。内漏是第二干预的最常见指征。 30天死亡率为10.5％（2/19）。手术治疗后观察到两名围手术期死亡。 TEVAR术后平均随访78.06±37.37个月（范围23-142个月），发生了4例无关的死亡，两名患者失去随访，四名患者需要进一步干预。结论腔内降主动脉血管内支架置入术后不需要二次干预，且风险可以接受。但是，连续，系统的随访对于发现晚期并发症和进行辅助手术至关重要，最好在选择性情况下进行。

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