主动脉弓FAN氏分型法再认识

FAN’s classification of aortic arch and its effect on endovascular aortic treatment

〔目的〕探讨主动脉弓FAN氏[1]分型亚型及对主动脉腔内修复策略的影响。〔方法〕回顾性分析收集2015年到2018年间,6例B型主动脉夹层腔内治疗后发生逆撕或内漏病例。分析CTA图像、植入支架直径放大率和特性、新发病变特点(时间、位置及形态)与主动脉弓部形态关系。〔结果〕6例患者均为F3型主动脉弓。术后6 d^3 a时间发现新发病变。发生逆撕4例,内漏2例。5例新发病变位于B区,1例位于A区。〔结论〕在涉及弓部腔内治疗风险评估、铆钉区确定及置入物选择时,FAN氏分型及亚型具有意义。

〔Objective〕To explore the aortic arch classification FAN's subtype and its effect on the strategy of endovascular aortic repair.〔Methods〕This study is a retrospective analysis. Between 2015 to 2018, 6 patients were treated by endovascular aortic repair, and then complicated with retrograde dissection or endoleak. We analyzed the relationship between CTA images, implanted stent diameter magnification and characteristics, characteristics of the new lesion ( time, location and morphology), and the aortic arch morphology.〔Results〕6 patients' aortic arch were type F3 aortic arch. New lesions were found 6 days to 3 years after operation, which involved 4 cases of retrograde dissection and 2 cases of endoleak. The location of the new lesion,5 cases in area B,1 case in area A.〔Conclusion〕When endovascular treatment involved aortic arch, the new FAN's classification and its subtype are more meaningful in risk assessment,rivet area selection and implant selection.