Ergebnisse nach Supraaortaler Stentangioplastie: Eine retrospektive Analyse
Für die Studienpopulation von 34 Patienten, die von 2002 bis 2012 mittels Stentangioplastie der Arteria subclavia und Truncus brachiocephalicus behandelt wurden, konnten die anfangs gestellten Fragestellungen folgendermaßen beantwortet werden: Von den 34 interventionell behandelten Patienten ware...
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Format: | Doctoral Thesis |
Language: | German |
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Philipps-Universität Marburg
2019
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Table of Contents:
For the study population of 34 patients who were treated from 2002 to 2012
with stentangioplasty of the subclavian artery and truncus
brachiocephalicus, the initial questions were answered as follows:
Of the 34 interventionally treated patients, 55.9% were male and 44.1%
female. The average age was 66.4 ± 11.39 years. 61.8% had hypertension,
5.9% had diabetes mellitus type 2 and 38.2% had hyperlipoproteinemia. 41,2%
of the patients were smokers. In the study population, oncological
pre-existing conditions were above average.
represented by 29.4%. An above-average number of closures were
recanalized. Patients with coronary heart disease were represented with
23.5%. They were
more cancers overall and with 35.3% more closures than in comparable
collectives. Technical and post-intervention clinical success was 91.2% on
average. The complication rate was 2.9%. There was an ischemia of the hand
due to an acute occlusion of the ipsilateral vertebral artery, brachial
artery and interosseous artery.
There were no transfusion-needy bleedings or direct periprocedural
deaths during the observation period.
There were no transfusion-needy bleedings or direct periprocedural deaths
during the observation period.
The primary patency rate was 81.0% after one year, 75.7% after two years,
68.8% after two years. after three years and 64.8% after five and ten years
respectively. The secondary openness rate over ten years was 83.3%. Total
mortality was 29.4%. Cumulative survival after ten years was 51.9%.
For smokers, a cumulative primary patency rate over ten years was 71.4%.
compared to 58.2% in the rest of the collective.
The cumulative primary openness rate over 10 years for the group of the
Hypertensive 63.8% and 67.3% respectively for the non-hypertensive group
The cumulative primary patency and for the collective without
hyperlipoproteinemia 55.4% over 10 years. The following mortality rates
were observed for cardiovascular risk factors: Smoking 14.3%, hypertension
38.1%, hyperlipoproteinemia 15.4%, diabetes mellitus without death.
Oncologic patients with pre-existing conditions showed lower primary
openness rates of 37.0% after 10 years. Both comorbidities showed an
increased mortality after 10 years: 60%.
in the group of oncologically pre-existing patients and 50% in the group of
those with coronary heart disease. As the only comorbidity, the risk factor
"previous oncological disease" showed a significance in the Fischer test
with p=0.03 with respect to the
Frequency for the event "death". In addition, patients with oncological
pre-existing conditions showed significantly the greatest
Risk for restenosis with a hazard ratio of 3.8 (1.05 - 13.82 95% KI;
p=0.04) in the Comparison with literature.
The study collectives showed patient numbers between 14 and 148 patients.
In the collectives, patients suffering from diabetes mellitus were much
more frequent.
than in our collective with only two cases. However, a comparatively low a
high incidence of oncologically ill patients in our collective. In the
Most studies did not mention the rate of oncological patients. Also more
closures were observed than in the reference collectives.
The technical and clinical success was comparable to that of the other
collectives. In the literature data, the primary openness rate for the
one-year period after stent implantation values between 92% and 100% are
given, and for the primary Long-term openness rate after 10 years values
between 49% and 67.3%. Thus our collective with 81.9%, for the one-year
primary openness rate among literature collectives but on average 64.8% for
the 10-year data. In summary, the long-term results of up to ten years with
the
Literature comparable data. Clinically, the vast majority of patients
showed a significant Symptom improvement can be achieved at a low
complication rate.
Thus, our study confirms the conclusion that the interventional therapy of
the Arteria subclavia and Truncus brachiocephalicus a safe and promising
treatment method, especially in symptomatic patients.