{"title":"冷冻象鼻手术治疗急性 A 型主动脉夹层:根据血管外科学会(SVS)/胸外科医师学会(STS)报告标准分析远端主动脉重塑情况。","authors":"","doi":"10.1016/j.avsg.2024.06.009","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>To investigate impact of frozen elephant trunk (FET) on long-term distal aortic remodeling in acute A aortic dissection (AAD) according to the latest recommended standards from the Society for Vascular Surgery (SVS)/Society of Thoracic Surgeons (STS).</p></div><div><h3>Methods</h3><p>Clinical data and imaging of patients who underwent FET to treat acute AAD over the last 8 years were retrospectively reviewed. Patients were included if a pre and postoperative computed angio tomographies at least 30 days from surgery was available for comparison. Contrasted postprocessed imaging were analyzed with Aquarius iNtuition (TeraRecon Inc., Foster City, CA, USA) to analyze long-term positive aortic remodeling, false lumen thrombosis, and aortic expansion according to the SVS or STS recommendations. Secondary endpoints were the rate of in-hospital and long-term mortality, spinal cord ischemia (SCI), and aortic-related reinterventions.</p></div><div><h3>Results</h3><p>Out of 75 patients who underwent FET for type A AAD, <em>n</em> = 41 (54.6%) were included. Significant positive aortic remodeling was reported in Ishimaru zone 1–4 but not in visceral or infrarenal aorta (<em>P</em> < 0.001), and the overall rate of false lumen thrombosis was 95.1% (<em>n</em> = 39). Aortic expansion rates were as follows: 4.9% in zones 1–4, 8.3% in zones 5–6, and 15% in zone 7. The rates of in-hospital mortality and long-term mortality were 7.3% (<em>n</em> = 3) and 9.7% (<em>n</em> = 4), respectively. At a median follow-up of 11 months (range 1–141, reintervention rate was 17.1%.</p></div><div><h3>Conclusions</h3><p>We report positive aortic remodeling of the distal thoracic aorta in patients who underwent FET for acute AAD according to the SVS or STS reporting standards. The positive effect on the distal aorta is limited to the thoracic segments but not in the visceral aorta.</p></div>","PeriodicalId":8061,"journal":{"name":"Annals of vascular surgery","volume":null,"pages":null},"PeriodicalIF":1.4000,"publicationDate":"2024-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Frozen Elephant Trunk Procedure for Acute Type a Aortic Dissection: Analysis of Distal Aortic Remodeling According to the Society for Vascular Surgery (SVS)/Society of Thoracic Surgeons (STS) Reporting Standard\",\"authors\":\"\",\"doi\":\"10.1016/j.avsg.2024.06.009\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><p>To investigate impact of frozen elephant trunk (FET) on long-term distal aortic remodeling in acute A aortic dissection (AAD) according to the latest recommended standards from the Society for Vascular Surgery (SVS)/Society of Thoracic Surgeons (STS).</p></div><div><h3>Methods</h3><p>Clinical data and imaging of patients who underwent FET to treat acute AAD over the last 8 years were retrospectively reviewed. Patients were included if a pre and postoperative computed angio tomographies at least 30 days from surgery was available for comparison. Contrasted postprocessed imaging were analyzed with Aquarius iNtuition (TeraRecon Inc., Foster City, CA, USA) to analyze long-term positive aortic remodeling, false lumen thrombosis, and aortic expansion according to the SVS or STS recommendations. Secondary endpoints were the rate of in-hospital and long-term mortality, spinal cord ischemia (SCI), and aortic-related reinterventions.</p></div><div><h3>Results</h3><p>Out of 75 patients who underwent FET for type A AAD, <em>n</em> = 41 (54.6%) were included. Significant positive aortic remodeling was reported in Ishimaru zone 1–4 but not in visceral or infrarenal aorta (<em>P</em> < 0.001), and the overall rate of false lumen thrombosis was 95.1% (<em>n</em> = 39). Aortic expansion rates were as follows: 4.9% in zones 1–4, 8.3% in zones 5–6, and 15% in zone 7. The rates of in-hospital mortality and long-term mortality were 7.3% (<em>n</em> = 3) and 9.7% (<em>n</em> = 4), respectively. At a median follow-up of 11 months (range 1–141, reintervention rate was 17.1%.</p></div><div><h3>Conclusions</h3><p>We report positive aortic remodeling of the distal thoracic aorta in patients who underwent FET for acute AAD according to the SVS or STS reporting standards. The positive effect on the distal aorta is limited to the thoracic segments but not in the visceral aorta.</p></div>\",\"PeriodicalId\":8061,\"journal\":{\"name\":\"Annals of vascular surgery\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.4000,\"publicationDate\":\"2024-07-14\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Annals of vascular surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0890509624004084\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"PERIPHERAL VASCULAR DISEASE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Annals of vascular surgery","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0890509624004084","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"PERIPHERAL VASCULAR DISEASE","Score":null,"Total":0}
引用次数: 0
摘要
目的根据血管外科学会(SVS)/胸外科医师学会(STS)的最新推荐标准,研究冰冻象鼻干(FET)对急性 AAD 远端主动脉长期重塑的影响:回顾性分析过去 8 年中接受 FET 治疗急性 AAD 患者的临床数据和影像学资料。如果术前和术后的计算机血管造影(Computed AngioTomographies)距手术至少有 30 天的时间可供比较,则纳入患者。根据 SVS/STS 建议,使用 Aquarius iNtuition(TeraRecon Inc.次要终点是院内死亡率和长期死亡率、脊髓缺血率以及主动脉相关的再干预率:在接受 FET 治疗的 75 名 A 型 AAD 患者中,有 41 人(54.6%)接受了治疗。石丸 1-4 区的主动脉重塑呈显著阳性,而内脏/肾内主动脉则没有(p结论:根据 SVS/STS 报告标准,我们报告了因急性 AAD 而接受 FET 的患者胸主动脉远端重塑的阳性结果。对远端主动脉的积极影响仅限于胸段,而不包括内脏主动脉。
Frozen Elephant Trunk Procedure for Acute Type a Aortic Dissection: Analysis of Distal Aortic Remodeling According to the Society for Vascular Surgery (SVS)/Society of Thoracic Surgeons (STS) Reporting Standard
Background
To investigate impact of frozen elephant trunk (FET) on long-term distal aortic remodeling in acute A aortic dissection (AAD) according to the latest recommended standards from the Society for Vascular Surgery (SVS)/Society of Thoracic Surgeons (STS).
Methods
Clinical data and imaging of patients who underwent FET to treat acute AAD over the last 8 years were retrospectively reviewed. Patients were included if a pre and postoperative computed angio tomographies at least 30 days from surgery was available for comparison. Contrasted postprocessed imaging were analyzed with Aquarius iNtuition (TeraRecon Inc., Foster City, CA, USA) to analyze long-term positive aortic remodeling, false lumen thrombosis, and aortic expansion according to the SVS or STS recommendations. Secondary endpoints were the rate of in-hospital and long-term mortality, spinal cord ischemia (SCI), and aortic-related reinterventions.
Results
Out of 75 patients who underwent FET for type A AAD, n = 41 (54.6%) were included. Significant positive aortic remodeling was reported in Ishimaru zone 1–4 but not in visceral or infrarenal aorta (P < 0.001), and the overall rate of false lumen thrombosis was 95.1% (n = 39). Aortic expansion rates were as follows: 4.9% in zones 1–4, 8.3% in zones 5–6, and 15% in zone 7. The rates of in-hospital mortality and long-term mortality were 7.3% (n = 3) and 9.7% (n = 4), respectively. At a median follow-up of 11 months (range 1–141, reintervention rate was 17.1%.
Conclusions
We report positive aortic remodeling of the distal thoracic aorta in patients who underwent FET for acute AAD according to the SVS or STS reporting standards. The positive effect on the distal aorta is limited to the thoracic segments but not in the visceral aorta.
期刊介绍:
Annals of Vascular Surgery, published eight times a year, invites original manuscripts reporting clinical and experimental work in vascular surgery for peer review. Articles may be submitted for the following sections of the journal:
Clinical Research (reports of clinical series, new drug or medical device trials)
Basic Science Research (new investigations, experimental work)
Case Reports (reports on a limited series of patients)
General Reviews (scholarly review of the existing literature on a relevant topic)
Developments in Endovascular and Endoscopic Surgery
Selected Techniques (technical maneuvers)
Historical Notes (interesting vignettes from the early days of vascular surgery)
Editorials/Correspondence