基于“PETTICOAT”技术的支架系统在B型主动脉夹层远端主动脉重构中的有效性分析——一项多中心“匹配”比较研究

Evaluation of a stent system based on "PETTICOAT" technique in distal aortic remodeling for type B aortic dissection: a multi-center "Matching" comparative study

目的比较采用Fabulous支架系统修复和标准胸主动脉腔内修复(TEVAR)对B型主动脉夹层(TBAD)远端主动脉的重塑效果。方法收集2017年12月至2019年10月经Fabulous支架治疗的134例TBAD患者以及对应的多中心进行标准TEVAR治疗的159例TBAD患者的数据。通过倾向性匹配分析,对比两组患者在术后1年的预后和主动脉重塑效果。结果通过倾向性匹配分析,一共62例Fabulous治疗的患者和匹配的62例标准TEVAR治疗的患者纳入分析。两组患者在术前基线情况方面差异无统计学意义。在裸支架区域的主动脉重塑方面,Fabulous组患者在真腔最小直径[10.6(4.4,14.5)mm比4.7(0.9,10.7)mm,P=0.001]和假腔最大直径[-24.2(-30.5,-4.9)mm比0.7(-11.8,2.3)mm,P<0.001]的变化趋势均优于标准TEVAR组患者,且Fabulous组患者的假腔完全血栓化比例明显优于标准TEVAR组患者(62.9%比37.1%,P=0.042)。结论TBAD患者采用Fabulous支架系统有更好的远端主动脉重塑效果。

Objective To compare the aortic remodeling of the Fabulous stent system and standard thoracic aortic endovascular repair(TEVAR)on distal aorta type B aortic dissection(TBAD).Methods The prospective data collected between Dec 2017 and Oct 2019 from 134 patients with type B aortic dissection(TBAD)who underwent treatment with the"Fabulous"stent system,and retrospective data from 159 TBAD patients receiving standard TEVAR from corresponding multicenter.By using propensity score matching analysis,we compared the prognosis and aortic remodeling outcomes in patients undergoing Fabulous and standard TEVAR treatments during a 1-year postoperative follow-up.Results In this study,62 patients in Fabulous group and 62 patients in standard TEVAR were included.There were no significant statistical differences in baseline characteristics between the two groups.In terms of aortic remodeling in bare stent region,Fabulous group had better change trends of diameter of true lumen[10.6(4.4,14.5)mm vs.4.7(0.9,10.7)mm,P=0.001]and false lumen[-24.2(-30.5,-4.9)mm vs.0.7(-11.8,2.3)mm,P<0.001]than those in the standard TEVAR group.The rate of complete false lumen thrombosis was also higher in the Fabulous group(62.9%vs.37.1%,P=0.042).Conclusion The Fabulous stent system,when compared to standard TEVAR surgery,demonstrates good aortic remodeling outcomes in the distal aorta.