颈动脉手术的短期疗效:一个教学中心的实际经验。

IF 0.8 Q4 PERIPHERAL VASCULAR DISEASE
Jornal Vascular Brasileiro Pub Date : 2024-02-05 eCollection Date: 2024-01-01 DOI:10.1590/1677-5449.202300332
Tércio Ferreira Oliveira, Carlos Diego Ribeiro Centellas, Marcelo Bellini Dalio, Edwaldo Edner Joviliano
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引用次数: 0

摘要

背景:对有症状的颅外颈动脉狭窄进行手术治疗可有效预防神经系统事件的发生,且应符合最佳质量标准。然而,人们越来越关注对照试验的结果是否可以在现实环境中复制:评估在专业培训中心接受手术的无症状颈动脉狭窄患者及其短期疗效:观察性研究使用从 2012 年 1 月至 2023 年 1 月的医疗记录中收集的数据。结果:共有70名患者接受了血管狭窄手术:共纳入70名接受血管成形术或颈动脉内膜剥脱术的患者。接受血管成形术或颈动脉内膜切除术的人群子集相似。在颈动脉内膜切除术亚组中,麻醉方式的差异和手术时间的延长具有统计学意义。共有 4 例中风,其中只有 3 例(2 例轻微中风,1 例严重中风)与指标病变有关。因此,与大手术相关的中风发生率为 1.43%,与任何病变相关的中风发生率为 4.29%。血管成形术组有 1 例急性心肌梗死,样本中没有死亡病例。主要不良心血管事件的总发生率为 5.71%。在主要结果方面,动脉内膜切除术组和血管成形术组之间没有统计学差异:结论:该中心的缺血性中风、急性心肌梗死、死亡和主要不良心血管事件的发生率与随机对照试验报告的发生率一致,表明在有教学计划的中心进行颈动脉手术是可行的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Short term outcomes of carotid surgery: the real-world experience of a single teaching center.

Background: Surgical treatment of symptomatic extracranial carotid stenosis is well established for preventing neurological events and should adhere to optimal quality standards. However, there is growing concern as to whether results of controlled trials are replicable in real-world settings.

Objectives: To assess a symptomatic carotid stenosis population that underwent surgery and its short-term outcomes in a real-world context at a professional training center.

Methods: Observational study using data collected from medical records from January 2012 to January 2023. Patients undergoing operations for other carotid diseases and with concomitant heart surgery were excluded.

Results: A total of 70 patients undergoing angioplasty or carotid endarterectomy were included. Population subsets undergoing angioplasty or endarterectomy were similar. Differences in anesthetic modality and a longer operative time in the carotid endarterectomy subgroup were statistically significant. There were 4 cases of stroke, only 3 of which (2 minor and 1 major) were related to the index lesion. Thus, the rate of major operation-related stroke was 1.43% and the rate of any lesion-related stroke was 4.29%. There was 1 case of AMI in the angioplasty group and there were no deaths in the sample. The overall rate of major adverse cardiovascular events was 5.71%. There were no statistical differences between the endarterectomy and angioplasty groups regarding the main outcomes.

Conclusions: The rates of outcomes of ischemic stroke, acute myocardial infarction, death, and major adverse cardiovascular events at this center are in line with the rates reported by randomized controlled trials, demonstrating the feasibility of carotid surgery in centers with teaching programs.

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来源期刊
Jornal Vascular Brasileiro
Jornal Vascular Brasileiro Medicine-Cardiology and Cardiovascular Medicine
CiteScore
1.20
自引率
0.00%
发文量
57
审稿时长
20 weeks
期刊介绍: The Jornal Vascular Brasileiro is editated and published quaterly to select and disseminate high-quality scientific contents concerning original research, novel surgical and diagnostic techniques, and clinical observations in the field of vascular surgery, angiology, and endovascular surgery. Its abbreviated title is J. Vasc. Bras., which should be used in bibliographies, footnotes and bibliographical references and strips.
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