JACC:支架或手术治疗股总动脉狭窄的比较

2017-07-04 xiangting MedSci原创

在有新动脉粥样硬化病变的CFA患者中,与手术相比,通过支架置入血管内治疗患者的围手术期发病率和死亡率明显降低。

TECCO试验是一项随机试验,旨在比较治疗股总动脉(CFA)狭窄时支架与开放手术的安全性和有效性。

CFA病变的手术被认为是有效和持久的。尽管血管内修复被广泛应用于腹股沟下疾病,但对这种病变进行这一手术的价值仍不确定。

2011年2月23日至2013年9月5日,共有117例新动脉粥样硬化的CFA患者被随机分为手术组(61例)或支架组(56例)。主要的排除标准是无症状疾病,再狭窄和CFA血栓形成。主要结果是30天内的发病率和死亡率。这包括导致或延长住院和/或再次干预的全身并发症或局部并发症,3天以上的淋巴瘘和需要药物的术后感觉异常。中位随访时间为2年(四分位数范围[IQR]:19.8-24.9年)。

手术组61例中16例(26%),支架组56例中7例(12.5%)发生主要结局事件(优势比2.5:95%置信区间:0.9-6.6; p = 0.05) 。支架组平均住院时间显著低于手术组(3.2±2.9天vs 6.3±3天; p <0.0001)。第24个月时,两组间持续临床改善,主要通畅率,靶病变和肢端血运重建率无差异。

在有新动脉粥样硬化病变的CFA患者中,与手术相比,通过支架置入血管内治疗患者的围手术期发病率和死亡率明显降低,而中期临床,形态学和血液动力学结果相当。

原始出处:
Yann Gouffic,et al. Stenting or Surgery for De Novo Common Femoral Artery Stenosis. JACC: Cardiovascular Interventions. July 2017.

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    2017-08-14 hbwxf
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