可控预开窗技术处理主动脉弓部病变的中期疗效

The mid-term results of the controllable pre-fenestration technique for the treatment of aortic arch pathologies

目的评价可控弓上预开窗技术治疗主动脉弓部病变的中期有效性和安全性。方法回顾性分析天津医科大学总医院血管外科2015年7月至2022年12月收治的167例采用腔内技术治疗主动脉弓部病变(Z1、Z2区)患者的临床及随访资料。结果两组手术成功率均为100%,预开窗组技术成功率97.26%,非预开窗组技术成功率95.74%,两组比较差异无统计学意义(P>0.05)。预开窗组的住院总费用低于非预开窗组(P<0.05)。预开窗组平均随访(63.92±25.23)个月,非预开窗组平均随访(37.63±21.48)个月,在随访期内,两组并发症、再干预情况及生存率差异无统计学意义(均P>0.05)。结论台上可控弓上预开窗技术治疗主动脉弓部疾病(Z1、Z2区)具备良好的中期有效性和安全性,住院总花费更少。

Objective To evaluate the medium-term efficacy and safety of the controlled supra-aortic pre-fenestration technique in the management of aortic arch lesions.Methods The clinical and follow-up data of 167 patients with aortic arch lesions located in the Z1 and Z2 zones and undergoing endovascular treatment at the Department of Vascular Surgery,Tianjin Medical University General Hospital from Jul 2015 to Dec 2022 were retroactively analyzed.Results The surgical success rate was 100% in both the pre-fenestration and non-pre-fenestration groups.Regarding technical success,the pre-fenestration group exhibited a rate of 97.26%,while the non-pre-fenestration group showed a rate of 95.74%(P>0.05).Cost in the pre-fenestration group was lower compared to the non-pre-fenestration group(P<0.05).The mean follow-up period were(63.92±25.23)months for the pre-fenestration group and(37.63±21.48)months for the non-pre-fenestration group.During the follow-up period,no significant differences were found in complications,reinterventions,and survival rates between the two groups(P>0.05).Conclusion Controlled supra-aortic pre-fenestration technique exhibits excellent medium-term efficacy and safety in the treatment of aortic arch diseases located in the Z1 and Z2 zones with lower total hospitalization costs.