Objective To analyse the clinical efficacy of carotid-subclavian artery diversion combined with thoracic aortic endovascular repair(TEVAR)hybrid technique for the treatment of type B aortic coarcta-tion.Methods A total of 45 patients with type B aortic coarctation admitted to the Department of Cardiac Macrovascular Surgery of the Inner Mongolia Autonomous Region People's Hospital from September 2021 to September 2022 were selected as study subjects.They were divided into hybridisation group and pre-opening group according to the different operation styles.A total of 24 cases in the promiscuous group were treated with carotid-subclavian artery diversion combined with TEVAR;A total of 21 cases in the preopening group were treated with extracorporeal LSA preopening technique combined with TEVAR,and the clinical characteristics,perioperative status,postoperative complications,and survival outcomes of the patients in the two groups were compared.Results There was no significant difference between the two groups in the baseline comparison of preoperative clinical characteristics,intraoperative endoleak rate,surgical success rate,postoperative complica-tions(cerebral infarction,left upper extremity ischemia,and incision infection)and other evaluation indexes(P＞0.05);and there were statistically significant differences in the surgical time,CICU custody time,hospi-tal costs,intraoperative bleeding,postoperative endoleak rate,and spinal cord ischemia(P＜0.05).The rates of postoperative endoleak and spinal cord ischaemia in the hybrid group were lower than those in the preopening group,and the rate of postoperative pain in the preopening group was lower than that in the hybrid group.Post-operative follow-up:one patient in the hybridisation group died on the 23rd postoperative day due to renal fail-ure;one patient in the preopening group died due to a cerebrovascular accident and one patient in the retrotear type A aortic coarctation.There was no statistically significant difference in mortality during follow-up in the hybridisation group compared with the pre-opening group(x2=0.014,P=0.905).Conclusion Both proce-dures can effectively reconstruct the left subclavian artery haemodynamics,but vascular diversion can significant-ly shorten the operation time,reduce the intraoperative bleeding,reduce the postoperative endoleak rate and spinal cord ischemia,so that the left subclavian artery has a better antegrade blood flow,which demonstrates a good therapeutic effect,and has the value of clinical application and promotion.
aortic coarctationvascular diversion techniquespreopeningendoluminal repair of the thoracic aorta
维普
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