数字减影技术在主动脉瘤微创腔内隔绝术中的应用  

DSA used in endovascular stent-grafts exclusion for aortic aneurysm.

作　　者：王家平[1] 李迎春[1] 郭立[1] 袁曙光[1] 闫东[1] 童玉云[1] 杨青[1] 韩正林[1] 

机构地区：[1]昆明医学院第二附属医院介入治疗中心,云南昆明650101

出　　处：《云南医药》2008年第2期122-123,共2页Medicine and Pharmacy of Yunnan

摘　　要：目的探讨对比剂追踪数字减影术(DSA),左前斜位DSA及DSA监视技术在胸腹主动脉瘤微创腔内隔绝术中的临床应用。方法33例胸腹主动脉瘤,其中胸主动脉夹层27例,腹主动脉真性动脉瘤5例,夹层1例,术前均行对比剂追踪DSA检查,使用系统的Mask Before程序,左前斜35°～60°(平均约45°)术中在DSA监视下经股动脉将移植物导入胸主动脉及腹主动脉瘤,行腔内隔绝术。术后均行DSA复查。结果33例造影图像质量优良,27例夹层清楚显示裂口位置及范围、真假腔情况及与左锁骨下动脉关系、腹主动脉瘤与肾动脉关系。全部在DSA监视下行带膜支架置入术。结论对比剂追踪DSA及斜位DSA能准确显示胸至腹主动脉情况、夹层撕裂范围及腹主动脉成角情况。术中DSA监视是成功释放隔绝物的关键。Objective To observe the clinical effect of bolus chasing DSA technology, left anterior oblique （LAO） section DSA,and DSA guiding technique used in the endovascular stent-grafts exclusion for thoracic aortic dissection （TAD） and abdominal aortic aneurysm（AAA） or dissection （AAD）. Methods 33 cases of TAD, AAD or AAA were included, 27 of which were TAD, 5 were AAA, and 1 was AAD. Bolus chasing DSA was performed before operation. Utilizing systemic Mask Before program at the position of LAO 35°-60° （average was 45°）, putting the stent-grafts into TAD and AAA under the guide of DSA, then exclusion was carried out. Re-examination was performed with DSA after operation. Results All of the 33 cases acquired good pictures of angiography. In the 27 cases of TAD, the position and size of the breach, the condition of true and false lumen,and their relation with left subclavian arteries, the relationship between AAA and renal arteries were shown clearly. All of the stent-grafts were implanted successfully under the guide of DSA. Conclusion Bolus chasing DSA and oblique section DSA can show the condition of TAD and AAA, the size of dissection, and the angle of abdominal aorta accurately, and the guide of DSA is a key factor to successful implant.

关 键 词：数字减影 血管造影术 支架 主动脉夹层及主动脉瘤 

分 类 号：R817.4[医药卫生—影像医学与核医学]