法国一中心慢性血栓形成后综合征血管内治疗的学习曲线。

IF 1.2 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS
Paul Segui, Valérie Monnin-Barès, Monira Nou, Sébastien Bommart, Hamid Zarqane, Juliette Vanoverschelde, Hélène Vernhet-Kovacsik
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引用次数: 0

摘要

目的:慢性血栓形成后综合征(PTS)是深静脉血栓形成(DVT)的常见致残性并发症,具有重要的临床影响。血管内支架植入术(EVS)已成为一种有效的技术,但其可用性仍然局限于专家中心。我们试图确定EVS治疗PTS学习曲线的关键决定因素,以及这一经验对我们短期和长期结果的影响,以促进区域传播并有效应对临床需求。材料和方法:我们回顾了8年来在本中心治疗的68例患者的记录。我们收集了患者和疾病的特征、手术的技术要素、手术期间的医疗管理以及临床随访和影像学的细节。结果:中位随访时间为37个月。原发性、原发性辅助和继发性通畅率分别为74%、86%和95%。从我们的活动开始,所有患者都观察到临床获益,无论操作人员的经验如何,都没有明显的变化。我们学习曲线的主要决定因素是对手术技术和准备的逐步掌握,材料的发展和术中管理的改进,允许减少干预时间,血管内修复率(38%至4%),p结论:EVS似乎是治疗PTS的有效治疗选择,即使由经验不足的操作员进行,也能观察到一致的临床改善。这项技术的改进带来了更快的手术,减少了术中和长期血栓事件的发生。实施这种类型的程序需要与血管医学和相应的血管学家多学科合作。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Learning curve in the endovascular treatment of chronic post-thrombotic syndrome in a French center.

Purpose: Chronic post-thrombotic syndrome (PTS) is a frequent and disabling complication of deep vein thrombosis (DVT) with significant clinical impact. Endovascular stenting (EVS) has established itself as an effective technique but its availability remains limited to expert centers. We sought to identify the key determinants of our learning curve in EVS for PTS and the impact of this experience on our short and long-term results, in order to facilitate territorial dissemination and respond effectively to clinical demand.

Material and methods: We reviewed the records of 68 patients treated in our centre during eight years. We collected patients and disease characteristics, technical elements of the procedure, peri-procedural medical management and detail of the clinical follow-up and imaging.

Results: The median follow-up was 37 months. The primary, primary assisted and secondary patency rates were respectively 74%, 86% and 95%. A clinical benefit was observed in all patients from the start of our activity, without significant change whatever the operator experience. The main determinants of our learning curve were a progressive mastery of the procedure in its technicality and preparation, the evolution of the material and the improvement of the peri procedural management, allowing to reduce the duration of intervention, the rate of endovascular revision (38% to 4%, p < 0.01) but also the number of remote thrombotic events (29% to 6%).

Conclusion: EVS appears to be an effective therapeutic option in the management of PTS, with consistent clinical improvement observed even when performed by less experienced operators. Improvement in this technique comes with faster procedures, and a reduction of the occurrence of peri-procedural and long term thrombotic events. The implementation of this type of procedure requires multi-disciplinary collaboration with vascular medicine and corresponding angiologists.

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来源期刊
CVIR Endovascular
CVIR Endovascular Medicine-Radiology, Nuclear Medicine and Imaging
CiteScore
2.30
自引率
0.00%
发文量
59
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