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[JAMA Surgery发布]:血管外科学会有关腹主动脉瘤患者诊治的实践指南
2019年05月11日 指南导读, 进展交流 暂无评论

JAMA Network Clinical Guideline Synopsis April 17, 2019

The Society of Vascular Surgery Practice Guidelines on the Care of Patients With Abdominal Aortic Aneurysms

Michol A. Cooper, Gilbert R. Upchurch Jr

JAMA Surg. Published online April 17, 2019. doi:10.1001/jamasurg.2019.0566

Guideline title: The Society for Vascular Surgery Practice Guidelines on the Care of Patients with an Abdominal Aortic Aneurysm

指南标题:血管外科学会腹主动脉瘤患者诊治实践指南

Developer: Society for Vascular Surgery

制订者:血管外科学会

Release date: January 2018

发布日期:2018年1月

Prior versions: 2003 and 2009

既往版本:2003年及2009年

Funding source: Society for Vascular Surgery

资金来源:血管外科学会

Target population: Physicians involved in preoperative, operative, and postoperative care of patients with abdominal aortic aneurysms (AAAs).

目标人群:参与腹主动脉瘤(AAA)患者术前、术中及术后诊治的医生

Major recommendations (with level of recommendation/quality of evidence rating):

主要推荐意见(推荐级别/证据质量评价)

Surveillance 监测

Ultrasonographic examination as the preferred surveillance method (1/A)

超声检查作为首选筛查手段(1/A)

One-time screening for patients aged 65 to 75 years with a history of tobacco use (1/A)

对于65-75岁有吸烟史的患者进行筛查(1/A)

Imaging every 3 years for AAAs of 3.0 to 3.9 cm (2/C)

针对3.0-3.9 cm的AAA每3年进行影像学检查(2/C)

Annual imaging for AAAs of 4.0 to 4.9 cm (2/C)

针对4.0-4.9 cm的AAA每年进行影像学检查(2/C)

Imaging twice per year for AAAs of 5.0 to 5.4 cm (2/C)

针对5.0-5.4 cm的AAA每半年进行影像学检查(2/C)

Decision to treat with elective repairs 择期修补治疗决策

Fusiform aneurysms of 5.5 cm or larger (1/A)

不小于5.5 cm的纺锤形动脉瘤(1/A)

All saccular aneurysms (2/C)

所有囊形动脉瘤(2/C)

Aneurysms of 5 cm or larger in women (2/B)

女性5 cm或更大的动脉瘤(2/B)

Operative approach 手术方式

Preserve at least 1 hypogastric artery (1/A)

保留至少一支腹下动脉(1/A)

Endovascular aneurysm repair recommended for ruptured AAA (1/C)

推荐进行血管内动脉瘤修补AAA破裂(1/C)

Endoleak treatment 内瘘处理

All type I endoleaks (1/B)

所有I型内瘘(1/B)

Type II endoleaks with aneurysm expansion (2/C)

II型内瘘伴动脉瘤增大(2/C)

All type III endoleaks (1/B)

所有III型内瘘(1/B)

Postoperative surveillance 术后监测

Post–endovascular aneurysm repair

血管内动脉瘤修补术后

Computed tomographic angiography and color duplex ultrasonography within 1 month (1/B)

一个月内复查CT血管造影及彩色多普勒超声检查(1/B)

Without endoleak or sac enlargement, annual imaging (1/B)

不伴内瘘或囊增大时,每年进行影像学检查(1/B)

Noncontrast computed tomography of entire aorta every 5 years after open surgical repair or endovascular aneurysm repair (2/C)

开放手术修补或血管内动脉瘤修补术后,每5年进行全主动脉的平扫CT检查(2/C)

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