今日の臨床サポート

腹部大動脈瘤

関連論文:
img  22:  Risk of reintervention after endovascular aortic aneurysm repair.
 
著者: A Karthikesalingam, P J E Holt, R J Hinchliffe, I M Nordon, I M Loftus, M M Thompson
雑誌名: Br J Surg. 2010 May;97(5):657-63. doi: 10.1002/bjs.6991.
Abstract/Text BACKGROUND: The role of symptomatic presentation in directing reintervention after endovascular aortic aneurysm repair (EVAR) was investigated.
METHODS: All patients undergoing infrarenal EVAR between 2001 and 2009 were studied. Those needing reintervention were divided into symptomatic and asymptomatic presentations. Kaplan-Meier survival curves were used to calculate freedom from reintervention, and log rank tests for subgroup analyses. Multivariable analysis identified risk factors for reintervention.
RESULTS: The study included 553 patients with a mean(s.d.) age of 75(7) years and aneurysm diameter of 65(13) mm. The 30-day mortality rate was 2.5 per cent. Median follow-up was 31 (range 1-97) months. There were 86 reinterventions in 69 (12.5 per cent) of 553 patients; 41 presented with symptoms and 28 were asymptomatic. Reintervention-free survival rates at 1, 3 and 5 years were 90.1, 85.3 and 81.2 per cent. The reintervention rate was higher in patients who needed an intraoperative adjunct during the index procedure (P = 0.014) and in those who did not have intraoperative computed tomography angiography (P = 0.024). Intraoperative adjuncts were an independent risk factor for future reintervention (hazard ratio 2.62, 95 per cent confidence interval 1.18 to 3.76; P = 0.012).
CONCLUSION: Most patients requiring reintervention presented symptomatically. A high-risk subgroup may be identifiable to rationalize a postoperative surveillance programme.

Copyright 2010 British Journal of Surgery Society Ltd.
PMID 20235086  Br J Surg. 2010 May;97(5):657-63. doi: 10.1002/bjs.6991.
戻る

さらなるご利用にはご登録が必要です。

こちらよりご契約または優待日間無料トライアルお申込みをお願いします。

(※トライアルご登録は1名様につき、一度となります)


ご契約の場合はご招待された方だけのご優待特典があります。

以下の優待コードを入力いただくと、

契約期間が通常12ヵ月のところ、14ヵ月ご利用いただけます。

優待コード: (利用期限:まで)

ご契約はこちらから