腹主动脉瘤相关II型内漏的血管内修复:一项关于进一步干预可能性的多中心研究

IF 2.8 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS
Frontiers in Cardiovascular Medicine Pub Date : 2025-04-17 eCollection Date: 2025-01-01 DOI:10.3389/fcvm.2025.1450942
E Erdemutu, Chongbin Zhou, Ming Ma, Liqiang Hu, Jisiguleng Wu, Xiangchen Dai, Zhanfeng Gao
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引用次数: 0

摘要

背景:我们旨在分析多中心腹主动脉瘤血管内动脉瘤修复(EVAR)后需要再干预的II型内漏(T2EL)的相关危险因素。方法:回顾性分析2017年1月至2021年12月天津医科大学总医院、内蒙古医科大学附属医院、山西省人民医院3个中心614例择期腹主动脉瘤EVAR患者的资料。应用排除标准后,共纳入375例患者,其中t2el相关再干预组50例,非t2el组325例。采用单因素和多因素logistic分析确定高危因素,采用ROC曲线分析确定肠系膜动脉直径、腰椎动脉数、最大动脉瘤直径、腔内血栓体积比例的危险阈值。结果:375例患者中,t2el相关再干预率为13.33%(50/375)。单因素分析显示,年龄、高血压、最大动脉瘤直径、腔内血栓比例、肠系膜下动脉直径(IMA)、腰椎动脉未闭数(LA)是t2el相关再干预的危险因素。多因素logistic分析发现最大动脉瘤直径、血栓比例、IMA直径和专利LA数量是影响EVAR后t2el相关再干预的主要因素。最大动脉瘤直径(OR = 1.043, 95% CI 1.015 ~ 1.072, P = 0.002)、IMA直径(OR = 3.901, 95% CI 1.116 ~ 13.632, P = 0.033)、LA数量(OR = 2.584, 95% CI 1.722 ~ 3.769, P)是再干预的重要危险因素。结论:具有确定危险因素的患者EVAR后t2el相关再干预的风险较高。超过新的风险阈值可能表明EVAR后发生t2el相关再干预的可能性更高。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Endovascular repair of abdominal aortic aneurysm-related type II endoleak: a multicenter study on the possibility of further intervention.

Background: We aimed to analyze the risk factors associated with Type II endoleak (T2EL) requiring reintervention after endovascular aneurysm repair (EVAR) for multicenter abdominal aortic aneurysms.

Methods: A retrospective analysis was conducted on data from 614 patients with abdominal aortic aneurysms who underwent elective EVAR at three centers (Tianjin Medical University General Hospital, Affiliated Hospital of Inner Mongolia Medical University, Shanxi Provincial People's Hospital) from January 2017 to December 2021. After applying exclusion criteria, 375 patients were included in the study, with 50 patients in the T2EL-related reintervention group and 325 patients in the non-T2EL group. Single-factor and multiple-factor logistic analyses were used to identify high-risk factors, and ROC curve analysis was performed to determine the risk thresholds for mesenteric artery diameter, number of lumbar arteries, maximum aneurysm diameter, and proportion of intraluminal thrombus volume.

Results: The rate of T2EL-related reintervention among the 375 patients was 13.33% (50/375). Single-factor analysis indicated that age, hypertension, maximum aneurysm diameter, proportion of intraluminal thrombus, diameter of inferior mesenteric artery (IMA), and number of patent lumbar arteries (LA) were risk factors for T2EL-related reintervention. Multiple-factor logistic analysis identified maximum aneurysm diameter, proportion of thrombus, IMA diameter, and number of patent LA as the main influencing factors for T2EL-related reintervention after EVAR. Significant risk factors for reintervention were maximum aneurysm diameter (OR = 1.043, 95% CI 1.015-1.072, P = 0.002), IMA diameter (OR = 3.901, 95% CI 1.116-13.632, P = 0.033), and number of LA (OR = 2.584, 95% CI 1.722-3.769, P < 0.001). A significant protective factor for reintervention was thrombus proportion (OR = 0.895, 95% CI 0.864-0.927, P < 0.001). ROC curve analysis showed that the risk thresholds for reintervention were an IMA diameter of 2.95 mm, intraluminal thrombus volume proportion <42.5%, number of LA ≤5.5, and aneurysm diameter of 53.55 mm.

Conclusion: Cases with identified risk factors are considered to have a higher risk of T2EL-related reintervention after EVAR. Exceeding the new risk thresholds may indicate a higher likelihood of T2EL-related reintervention after EVAR.

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来源期刊
Frontiers in Cardiovascular Medicine
Frontiers in Cardiovascular Medicine Medicine-Cardiology and Cardiovascular Medicine
CiteScore
3.80
自引率
11.10%
发文量
3529
审稿时长
14 weeks
期刊介绍: Frontiers? Which frontiers? Where exactly are the frontiers of cardiovascular medicine? And who should be defining these frontiers? At Frontiers in Cardiovascular Medicine we believe it is worth being curious to foresee and explore beyond the current frontiers. In other words, we would like, through the articles published by our community journal Frontiers in Cardiovascular Medicine, to anticipate the future of cardiovascular medicine, and thus better prevent cardiovascular disorders and improve therapeutic options and outcomes of our patients.
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