腔内隔绝术中胸主动脉夹层动脉瘤假腔的DSA评估

Evaluation of the False Lumen with DSA in Endovascular Exclusion for Thorocic Aortic Dissection

目的 探讨针对胸主动脉夹层 (TAD)动脉瘤腔内隔绝术 (EVE)中DSA评估假腔的意义。方法 116例TAD在术中经真腔置管延迟DSA和假腔置管DSA观察假腔显影的过程。结果 新发现多裂口 8例 ,肋间动脉起自假腔 7例。经假腔置管评估 5例 ,其中帮助裂口评估 2例 ;导管定位 2例 ;新发现第二裂口 1例 ;经假腔置备用治疗管 2例。所有内漏均经假腔评估决定了处理措施。结论 EVE术中对假腔进行DSA评估可弥补术前其他影像学检查的不足 ,有助于发现多裂口的存在 ,并对预防截瘫、内漏决策、疗效观察等起到重要作用。

Objective To discuss the value of evaluating the false lumen with DSA in endovascular exclusion (EVE) for thoracic aortic dissection (TAD). Methods In the operation, catheters were sent into the true lumen with delayed aortography and into the false lumen with direct aortography to assay the false lumen. Results Multi tears were revealed additionally in 8 cases, and the intercostal arteries rooting from the false lumen in 7 cases. Among five cases that evaluated by intra false lumen detection, tears were evaluated in two cases, catheter orientating in two, second tear detecting in one, and standby catheters were placed in two. Conclusion In the procedure of EVE, evaluating the false lumen with DSA may complement the deficiency of other imaging methods, which is benefit in detecting multi tears, and valuable in prevention of paraplegia, choice making when endoleak exists, and evaluating the effectiveness.