摘要
目的探讨胸主动脉的解剖特点，以证明B型主动脉夹层病人主动脉弓直径与降主动脉真腔直径存在显著差异。方法20名健康成年人为对照组，接受计算机x射线断层血管造影（erA）测量主动脉弓直径（近端西）和降主动脉中段直径（远端中）。病程小于1个月的急性组23例和病程大于2年的慢性组19例病人均接受了主动脉夹层腔内修复术，利用术中的数字减影（DSA）和术前、术后的CTA，测量主动脉弓直径（近端西）和降主动脉中段真腔直径（远端中）。分别计算3组的渐细率[（近端中-远端垂），近端垂）×100％]。结果对照组的CrA渐细率为（13．0±4．7）％。急性组DSA和CTA的渐细率分别为（23．6±11．3）％和（21．9±12．1）％。慢性组DSA和CTA的渐细率分别为（31．5±13．6）％和（30．1±11．4）％。结论在急性和慢性B型夹层病人中，主动脉弓直径显著大于降主动脉真腔直径。在B型主动脉夹层腔内修复术中使用渐细型覆膜支架是一个更合理的选择。
Objective Type B aortic dissection has unique anatomical features compared with other aortic conditions. We hy- pothesize that in patients with type B aortic dissection, there is significant difference between arch diameter and tree lumen diameter in the descending aorta. Methods The diameters of the aortic arch （proximal φ） and mid-descending aorta （distain） were measured on computered tomography angiography （CrA） in 20 healthy adult control group. Forty-two patients with type B aortic dissection who underwent endovaseular repair were divided into two groups： an acute group （23 patients） and a chronic group （ 19 patients）. In the acute group, the time from onset of dissection to stent-graft implantation was less than one month. In the chronic group, the time from onset of dissection to stent-graft implantation was more than 2 years （range 2 - 10 years）. The diameters of the arch （proximal φ） and the true lumen of the mid-descending aorta （distain）were measured on digital subtraction angiography （DSA） during the endovascular repair and on CTA one week after the repair. The taper ratio was defined as （proximalφ- Distal φ）/（Proximal φ） × 100% and was calculated in aU three o＇oups. Results In the control group, the taper ratio was （13.0±4.7）% onCTA. In the acute aortic dissection group, the taper ratio was （ 23.6 ± 11.3） % on DSA and （ 21.9 ± 12.1 ） % on CTA. In the chronic aortic dissection group, the taperratiowas（31.5±13.6）% onDSAand（30.1±11.4）% onCTA. Conclusion In both acute and chronic type B aortic dissection, the aorta tapers significantly from arch to true lumen in the descending aorta. Stent-graft with tapered design way be a rational rational option for option for endovascular repair of type B aortic dissection.
出处
《中华胸心血管外科杂志》
CSCD
北大核心
2008年第5期292-295,共4页
Chinese Journal of Thoracic and Cardiovascular Surgery
关键词
主动脉疾病
支架
心脏外科手术
Aortic diseases Stents Cardiac surgical procedures
