胸主动脉腔内治疗相关的主动脉弓形态研究  

Research of thoracic aortic endovascular treatment relevant aortic arch morphology

作　　者：严宇[1] 严中亚[1] 邓克学[1] 申运华[1] 

机构地区：[1]安徽省立医院心脏外科,安徽省合肥市230001

出　　处：《中国心血管病研究》2017年第1期18-22,I0001,I0002,共7页Chinese Journal of Cardiovascular Research

摘　　要：目的 通过对主动脉弓CT血管造影（CTA）资料的回顾性研究,了解正常主动脉弓的解剖形态学特点,为腔内治疗技术及人工血管和新型支架的设计建立解剖形态学基础.方法 选择2009年1月至2012年10月符合入组标准的正常型主动脉弓CTA资料共217例,使用GE公司AW4.5工作站测量升主、弓上分支的直径及分支之间的距离,运用统计学软件进行分析.结果 冠状动脉开口上2 cm处主动脉直径为（34.56±4.72）mm,分支动脉开口直径：无名动脉为（12.50±1.95）mm、左颈总动脉为（8.28±1.51）mm、左锁骨下动脉为（10.41±2.20）mm.主动脉弓横断面上无名动脉和左锁骨下动脉连线与矢状面的成角为（50.30±13.79）°.无名动脉与颈总动脉距离为（4.39±2.49）mm,左颈总动脉与左锁骨下动脉距离为（6.43±3.98）mm.不同年龄组主动脉直径差异显著,61岁以上年龄组主动脉直径明显大于18～40岁和41～60岁年龄组.结论 ①在进行主动脉腔内修复术时,选择支架应充分考虑61岁以上患者主动脉直径有明显增大趋势.②由于近端锚定区距离过小,涉及左锁骨下动脉的主动脉病变大部分是不可能通过简单地扩展胸主动脉腔内支架来成功处理.Objective To investigate the anatomical morphological characteristics of the normal aortic arch and then guide the development of artificial blood vessel and new aortic endovascular treatment equipment. Methods The multislice CT angiography Figures of 217 patients with normal aortic arch scanned from January 2009 to October 2012 which were in accordance with the inclusion criteria were collected. Quantitatively measured the branch location of the innominate artery, the left common carotid artery and the left subclavian artery in the aortic arch, as well as the distance between the branch vessels and the diameter of the branch vessels, and the angle between the sagittal plane of the aortic arch and the connection line of the innominate artery and the left subclavian artery in the cross section of the aortic arch. Results The distance between the innominate artery and the left common carotid artery was （4.39±2.49）mm, the left common carotid artery-the left subclavian artery was （6.43±3.98）mm. Diameter of the opening of the branch arteries： the innominate artery was （12.50±1.95）mm, the left common carotid artery was （8.28±1.51）mm, the left subclavian artery was （10.41±2.20）mm. The diameter of aortic was （34.56±4.72）mm. The average angle between the sagiittal plane and the connection line of the innomi- nate artery and the left subclavian artery in the cross section of the aortic was （50.30±13.79）°. There was statisti- cally significant difference （P〈0.05） in the diameter of the aortic between different ages. The diameter of the aor- tic was significantly large in cases that more than 61 years old than that in cases of 18-40 years old as well as of 41-60 years old. The distance between the branches： innominate artery-the left common carotid artery was （4.39± 2.49）mm, the left common carotid artery-the left subclavian artery was（6.43±3.98）mm. Conclusion The tenden- cy of increased aortic diameter in more than 61 years old people should be fully considered when ch

关 键 词：主动脉弓 CT血管造影 解剖形态学 

分 类 号：R654.2[医药卫生—外科学]