山东大学学报 (医学版) ›› 2024, Vol. 62 ›› Issue (9): 26-29.doi: 10.6040/j.issn.1671-7554.0.2024.0341
• 主动脉疾病基础与临床研究进展专刊—研究进展 • 上一篇 下一篇
史潇兮,辛世杰
SHI Xiaoxi, XIN Shijie
摘要: 腹主动脉瘤(abdominal aortic aneurysm, AAA)是血管外科的常见疾病,传统开放手术(open aortic repair, OAR)或腔内修复(endovascular aortic repair, EVAR)是仅有的有效治疗手段。OAR在20世纪50至90年代达到鼎盛,因其本身的创伤性、技术的复杂性、EVAR技术的迅猛发展等原因,应用已逐渐减少,但在基础研究、年轻患者及感染性AAA等情况中,OAR的作用仍然不可替代。本文回顾OAR的历史和现状,分析其优势和劣势,并讨论术中关键技术要点及并发症的处理,总结在EVAR时代OAR所扮演的角色和地位。
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| [1] Johnston KW, Rutherford RB, Tilson MD, et al. Suggested standards for reporting on arterial aneurysms[J]. J Vasc Surg, 1991, 13(3): 452-458. [2] Sakalihasan N, Michel JB, Katsargyris A, et al. Abdominal aortic aneurysms[J]. Nat Rev Dis Primers, 2018, 4(1): 34. [3] Golledge J, Muller J, Daugherty A, et al. Abdominal aortic aneurysm: pathogenesis and implications for management[J]. Arterioscler Thromb Vasc Biol, 2006, 26(12): 2605-2613. [4] Golledge J. Abdominal aortic aneurysm: update on pathogenesis and medical treatments[J]. Nat Rev Cardiol, 2019, 16(4): 225-242. [5] Sampson UKA, Norman PE, et al. Global and regional burden of aortic dissection and aneurysms: mortality trends in 21 world regions, 1990 to 2010[J]. Glob Heart, 2014, 9(1): 171-180. [6] Friedman SG. The 50th anniversary of abdominal aortic reconstruction[J]. J Vasc Surg, 2001, 33(4): 895-898. [7] Blakemore AH, Jr Voorhees AB. The use of tubes constructed from vinyon N cloth in bridging arterial defects; experimental and clinical[J]. Ann Surg, 1954, 140(3): 324-334. [8] 董雨亭, 段志泉, 谷树人, 等. 腹及胸腹主动脉瘤的外科治疗(附9例报告)[J]. 实用外科杂志, 1988, 8(9): 471-473. DONG Yuting, DUAN Zhiquan, GU Shuren, et al. Surgical treatment of abdominal and thoracoabdominal aortic aneurysm(report of 9 cases)[J]. Chinese Journal of Practical Surgery, 1988, 8(9): 471-473. [9] Parodi JC, Palmaz JC, Barone HD. Transfemoral intraluminal graft implantation for abdominal aortic aneurysms[J]. Ann Vasc Surg, 1991, 5(6): 491-499. [10] Rouwet EV, Torsello G, de Vries JP, et al. Final results of the prospective European trial of the Endurant stent graft for endovascular abdominal aortic aneurysm repair[J]. Eur J Vasc Endovasc Surg, 2011, 42(4): 489-497. [11] Boyle JR, Mao J, Beck AW, et al. Variation in intact abdominal aortic aneurysm repair outcomes by country: analysis of international consortium of vascular registries 2010-2016[J]. J Vasc Surg, 2021, 74(2): 679. [12] Patel R, Sweeting MJ, Powell JT, et al. EVAR trial investigators. Endovascular versus open repair of abdominal aortic aneurysm in 15-years follow-up of the UK endovascular aneurysm repair trial 1(EVAR trial 1): a randomised controlled trial[J]. Lancet, 2016, 388(10058): 2366-2374. [13] Antoniou GA, Antoniou SA, Torella F. Editors choice-endovascular vs. open repair for abdominal aortic aneurysm: systematic review and meta-analysis of updated peri-operative and long term data of randomised controlled trials[J]. Eur J Vasc Endovasc Surg, 2020, 59(3): 385-397. [14] Chang DC, Parina RP, Wilson SE. Survival after endovascular vs open aortic aneurysm repairs[J]. JAMA Surg, 2015, 150(12): 1160-1166. [15] Chaikof EL, Dalman RL, Eskandari MK, et al. The Society for Vascular Surgery practice guidelines on the care of patients with an abdominal aortic aneurysm[J]. J Vasc Surg, 2018, 67(1): 2-77. [16] Wanhainen A, Verzini F, Van Herzeele I, et al. Editors choice-European society for vascular surgery(ESVS)2019 clinical practice guidelines on the management of abdominal aorto-iliac artery aneurysms[J]. Eur J Vasc Endovasc Surg, 2019, 57(1): 8-93. [17] Abdominal aortic aneurysm: diagnosis and management[M]. London: National Institute for Health and Care Excellence(NICE), 2020. https://www.ncbi.nlm.nih.gov/books/NBK556921/. [18] Ogino H, Iida O, Akutsu K, et al. JCS/JSCVS/JATS/JSVS 2020 guideline on diagnosis and treatment of aortic aneurysm and aortic dissection[J]. Circ J, 2023, 87(10): 1410-1621. [19] 辛世杰, 张珈玮, 张健, 等. 单中心近10年腹主动脉瘤1 246例流行病学研究[J]. 中国实用外科杂志, 2021, 41(12): 1384-1393. XIN Shijie, ZHANG Jiawei, ZHANG Jian, et al. Epidemiological study of 1,246 cases of abdominal aortic aneurysm from a single center in the last 10 years[J]. Chinese Journal of Practical Surgery, 2021, 41(12): 1384-1393. [20] Wang L, Xin SJ, Song Z, et al. Left renal vein division during open surgery of abdominal aortic disease: a propensity score-matched case-control study[J]. Eur J Vasc Endovasc Surg, 2013, 46(2): 227-231. [21] Sicard GA, Reilly JM, Rubin BG, et al. Transabdominal versus retroperitoneal incision for abdominal aortic surgery: report of a prospective randomized trial[J]. J Vasc Surg, 1995, 21(2): 174-181;discussion 181-183. [22] Welch HJ. Retroperitoneal approach for aortic surgery: is it worth it?[J]. Cardiovasc Surg, 2002, 10(2): 185. [23] Robertson L, Nandhra S. Laparoscopic surgery for elective abdominal aortic aneurysm repair[J]. Cochrane Database Syst Rev, 2017(5). doi:10.1002/14651858.cd012302. [24] Rusch R, Hoffmann G, Rusch M, et al. Robotic-assisted abdominal aortic surgery: evidence and techniques[J]. J Robot Surg, 2022, 16(6): 1265-1271. [25] Charlton-Ouw KM, Sandhu HK, Huang G, et al. Reinfection after resection and revascularization of infected infrarenal abdominal aortic grafts[J]. J Vasc Surg, 2014, 59(3): 684-692. [26] Oderich GS, Bower TC, Hofer J, et al. In situ rifampin-soaked grafts with omental coverage and antibiotic suppression are durable with low reinfection rates in patients with aortic graft enteric erosion or fistula[J]. J Vasc Surg, 2011, 53(1): 99-106, 107. [27] Oda T, Minatoya K, Kobayashi J, et al. Prosthetic vascular graft infection through a Median sternotomy: a multicentre review[J]. Interact Cardiovasc Thorac Surg, 2015, 20(6): 701-706. |
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