脾动脉的外科治疗_杨宁介入医学网

血管内治疗 vs 外科治疗

结论: 内脏动脉瘤(VAA)的腔内修复术逐渐增多。尽管患者有较严重的合并症和更多的非择期性住院，但血管内治疗似乎与死亡率和并发症的降低以及住院时间的缩短相关。

Chin, et al. JVS 2017

• 9260 interventions from 2003 to 2013

• 5166 endovascular, 4094 open

• More endovascular repairs over time as compared with open repair

• In-hospital mortality (4.1% vs 4.5%; P = .618) similar between groups

• Pulmonary complications decreased for endovascular patients (10.6% vs 19.7%; P < .001)

• Shorter hospital stays for endovascular patients (6.5 vs 8.7 days; P < .001)

• Multivariate adjustment for mortality predictors, showed open repair associated with increased mortality (OR, 1.70; CI, 1.03-2.81; P = .04)

• Multivariate analysis of overall complications showed open repair associated with increased complications (OR, 1.78; CI, 1.43-2.21; P < .001)

Batagini N, et al. JVS 2015

• 2007 and April 2015, 57 treated with endovascular (group 1) and 56 by open approach (group 2)

• No significant differences between the two groups with incidence of intraoperative and postoperative major complications, including end-organ infarction, and reinterventions

• Transfusion of blood products was necessary in 12.3% (group 1) and 42.9% (group 2) (P < .001)

• Median hospital length of stay was 1 day (IR, 1-3 days) and 6 days (IR, 4-9 days) in groups 1 and 2, respectively (P < .001)

• During the median follow-up period of 16 months (IR, 7.1-43.9 months), technical success was 94.7% in group 1 and 92.8% in group 2 (P = .71)

• Overall survival was 94.7% and 96.4% in groups 1 and 2, respectively (P = 1.0)

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