成人股骨头缺血性坏死患者股深动脉及其分支变异的血管造影分析

Angiographic analysis of variation of femoral deep artery and its branches in adult patients with avascular necrosis of femoral head

目的对成人股骨头缺血性坏死患者的股深动脉及其分支血管造影结果进行分析,探讨股深动脉及其分支变异与股骨头缺血性坏死的相关性。方法回顾性分析自2001-01—2022-02进行介入手术治疗的25例(27个股骨头)成人股骨头缺血性坏死(坏死组),纳入同期进行数字减影血管造影检查明确未出现股骨头缺血性坏死且股骨头供血血管正常的8例(8个股骨头)作为正常组对照。选择股深动脉、旋股内侧动脉、旋股外侧动脉显影最清晰、动态观察效果最好、血液无中断的图片,用处理软件放大图片,测量相关指标并进行比较分析。结果坏死组股深动脉长度、股深动脉直径大于正常组,股动脉与股深动脉夹角小于正常组,差异有统计学意义(P<0.05)。坏死组与正常组旋股内侧动脉开口后走行类型、旋股内侧动脉直径、旋股内侧动脉与主干夹角差异无统计学意义(P>0.05)。坏死组与正常组旋股外侧动脉长度差异无统计学意义(P>0.05);坏死组旋股外侧动脉直径大于正常组,旋股外侧动脉与股深动脉夹角小于正常组,差异有统计学意义(P<0.05)。结论股深动脉及其分支变异可能是导致成人股骨头缺血性坏死的一个重要因素,需引起临床医师足够的重视。

Objective To analyze femoral deep artery and its branch vascular angiography results in adult patients with avascular necrosis of the femoral head and investigate the correlation between variations in the femoral deep artery and its branches and avascular necrosis of the femoral head.Methods A retrospective analysis was conducted on 25 cases(27 femoral heads)of avascular necrosis of the femoral head in adult patients who underwent interventional surgical treatment from January 2001 and February 2022,referred to as the necrosis group.Eight cases(8 femoral heads)with normal findings of femoral head perfusion and no evidence of avascular necrosis during digital subtraction angiography within the same period were included as the control group,referred to as the normal group.The femoral deep artery,medial circumflex femoral artery,and lateral circumflex femoral artery images with the clearest visualization,optimal dynamic observation,and uninterrupted blood flow were selected.These images were enlarged using processing software,and relevant parameters were measured and subjected to comparative analysis.Results In the necrosis group,the length and diameter of the femoral deep artery were greater than those in the normal group,while the angle between the femoral artery and the femoral deep artery was smaller than that in the normal group,with statistically significant differences(P<0.05).There were no statistically significant differences between the necrosis and normal groups in terms of the course type,diameter,and angle between the medial circumflex femoral artery and its main stem after its origin(P>0.05).The length of the lateral circumflex femoral artery showed no statistically significant difference between the necrosis and normal groups(P>0.05).However,in the necrosis group,the diameter of the lateral circumflex femoral artery was greater than that in the normal group,and the angle between the lateral circumflex femoral artery and the femoral deep artery was smaller than that in the normal group,with statistically significant differences(P<0.05).Conclusion Variations in the femoral deep artery and its branches may represent a significant contributing factor to the development of avascular necrosis of the femoral head in adults.This phenomenon warrants ample attention from clinicians in the field.