CAJ | 학술논문

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(CTA)测量主动脉弓直径(近端Φ)和降主动脉中段直径(远端Φ).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Φ)和降主动脉中段真腔直径(远端Φ).分别计算3组的渐细率[(近端φ-远端Φ)/近端Φ)×100%].结果对照组的CTA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.
목적 탐토흉주동맥적해부특점,이증명B형주동맥협층병인주동맥궁직경여강주동맥진강직경존재현저차이.방법 20명건강성년인위대조조,접수계산궤X사선단층혈관조영(CTA)측량주동맥궁직경(근단Φ)화강주동맥중단직경(원단Φ).병정소우1개월적급성조23례화병정대우2년적만성조19례병인균접수료주동맥협층강내수복술,이용술중적수자감영(DSA)화술전、술후적CTA,측량주동맥궁직경(근단Φ)화강주동맥중단진강직경(원단Φ).분별계산3조적점세솔[(근단φ-원단Φ)/근단Φ)×100%].결과 대조조적CTA점세솔위(13.0±4.7)%.급성조DSA화CTA적점세솔분별위(23.6±11.3)%화(21.9±12.1)%.만성조DSA화CTA적점세솔분별위(31.5±13.6)%화(30.1±11.4)%.결론 재급성화만성B형협층병인중,주동맥궁직경현저대우강주동맥진강직경.재B형주동맥협층강내수복술중사용점세형복막지가시일개경합리적선택.
Objective Type B aortic dissection has unique anatomical features compared with other aortic conditions. We hypothesize that in patients with type B aortic dissection, there is significant difference between arch diameter and true lumenan diameter in the descending aorta. Methods The diameters of the aortic arch (proximalΦ) and mid-descending aorta (distalΦ) were measured on computered tomography angiography (CTA) in 20 healthy adult control group. Forty-two patients with type B aortic dissection who un-dorwant endovascular repair were divided into two gronps: an acute group (23 patients) and a chronic group (19 patients). In the acute gronp, 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- I0 years). The diameters of the arch(proximalΦ) and the true lumen of the mid-descending aorta (distalΦ)were measured on digital subtraction angiography (DSA) during the endovascular repair and on CTA one week after the repair. The tapor ratio was defined as (proximalΦ- Distal Φ)/(Proximal Φ)×100% and was calculated in all three groups. Results In the vontrol group, the taper ratio was(13.0±4.7)% On CTA. In the acute aortic dissec-tion group, the taper ratio was (23.6±11.3)% on USA and (21.9±12.1)% on CTA. In the chronic aortic dissection group, the taper ratio was (31.5±13.6)% on USA and (30.1±11.4)% on CTA. Conclusion In both acute and chronic type B aortic dis-section, the aorta tapers significantly from arch to true lumen in the descending aorta. Stant-graft with tapered design may be a rational treatment option for endovascular repair of type B aortic dissection.