共查询到20条相似文献,搜索用时 31 毫秒
1.
目的 探讨累及心血管系统的Behcet综合征影像特点及其诊断.方法 搜集1995年7月至2007年12月临床诊断为Behcet综合征累及心血管系统患者11例的电子束CT(EBCT)或64层MSCT检查资料,回顾分析其cT影像特点.结果 11例Behcet综合征患者的CT影像表现为:累及主动脉瓣4例(其中2例同时累及二尖瓣),右冠状动脉假性动脉瘤2例(其中1例同时形成右腋动脉假性动脉瘤,3.5年后无诱因出现腹主动脉假性动脉瘤),左锁骨下动脉假性动脉瘤1例(伴腹主动脉下段闭塞),主动脉弓部真性动脉瘤及溃疡1例,主动脉弓部假性动脉瘤1例,主动脉夹层1例,肺动脉栓塞伴房间隔瘤1例.结论 CT作为Behcet综合征诊断及定期随访的检查手段,可明确心血管系统受累情况,根据其病变的影像特点,为选择临床治疗方法提供依据. 相似文献
2.
Chris Klonaris Efthimios D. Avgerinos Athanasios Katsargyris Alexandros Matthaiou Sotirios Georgopoulos Vasileios Psarros Elias Bastounis 《Cardiovascular and interventional radiology》2009,32(4):758-761
This case report describes the endovascular repair of a right-sided descending thoracic aortic aneurysm associated with a
right aortic arch and an aberrant left subclavian artery. A 76-year-old male with multiple comorbidities was incidentally
found to have a right-sided descending thoracic aortic aneurysm with a maximum diameter of 6.2 cm. Additionally, there was
a right aortic arch with a retroesophageal segment and separate arch branches arising in the following order: left common
carotid artery, right common carotid artery, right subclavian artery, and left subclavian artery that was aberrant, arising
from a Kommerrell’s diverticulum. The aneurysm was successfully excluded by deployment of a Zenith TX1 36 × 32 × 20-mm stent-graft
using wire traction technique via the left femoral and right brachial arteries in order to deal with two severe aortic angulations.
At 18-month follow-up the patient was doing well, with aneurysm sac shrinkage to 5.9 cm and no signs of endoleak or migration.
Endovascular repair of right-sided descending thoracic aortic aneurysms with a right arch and aberrant left subclavian artery
is feasible, safe, and effective. In such rare configurations, which demand considerably increased technical dexterity and
center experience, endovascular repair emerges as an attractive therapeutic option. 相似文献
3.
Summary A verified case of duplicate origin of the left vertebral artery in association with a large aneurysm arising from the aortic arch immediately distal to the left subclavian artery is presented. An anomalous left vertebral artery arises directly from the aortic arch between the left common carotid and subclavian arteries, and joins with the normal left vertebral artery in the transverse foramen of the fifth cervical vertebra. 相似文献
4.
Munneke GJ Loosemore TM Belli AM Thompson MM Morgan RA 《Cardiovascular and interventional radiology》2005,28(5):653-655
An aberrant right subclavian artery (ARSA) arising from a left-sided aortic arch is the fourth most common aortic arch anomaly.
Aneurysmal dilatation of the ARSA requires treatment because of the associated risk of rupture. We present a case where supra-aortic
bypass of the arch vessels was performed to facilitate exclusion of the aneurysm by a thoracic aortic stent graft. 相似文献
5.
Summary A previously healthy heroin addict died suddenly and unexpectedly of hemothorax due to rupture of a subclavian artery aneurysm. He had been using the neck veins for mainlining. The pathogenesis of the aneurysm is discussed. 相似文献
6.
Beissert M Jenett M Trusen A Wittenberg G Krause U Gassel HJ Hahn D 《European radiology》2000,10(3):459-461
True aneurysms of otherwise normal subclavian arteries are uncommon peripheral vascular anomalies. Most patients with subclavian
artery aneurysms are symptomatic by presenting neurologic signs. We report a young woman who had an asymptomatic true aneurysm
of the right subclavian artery assumed to be of congenital origin. This case is unique in that the aneurysm was in the extremely
rare anatomic location of the right supraclavicular fossa between the origins of the right subclavian artery and the vertebral
artery. Aneurysms of the right subclavian artery may represent a potential pitfall in conventional gray-scale ultrasound of
the neck particularly the supraclavicular fossa. Differential diagnosis includes cervical cyst, pharyngo-esophageal diverticulum,
vascular anomalies, struma, enlarged lymph node, as well benign or malignant neoplasms. Color duplex ultrasound should be
performed as the method of choice for further analysis of suspected aneurysms. In this report the role of B-mode ultrasound
and color duplex ultrasound is discussed in relation to digital subtraction- and MR angiography in confirmation of the diagnosis.
Received: 5 January 1999; Revision received: 26 April 1999; Accepted: 18 June 1999 相似文献
7.
W H Shuford R G Sybers I J Gordon M G Baron G C Carson 《AJR. American journal of roentgenology》1986,146(3):491-496
The authors present three cases of circumflex right aortic arch, a retroesophageal arch in which the aorta crosses from right to left behind the esophagus to descend on the left side. The findings on the frontal chest films resembled those of a left arch with mediastinal widening, simulating a mass. Aortography revealed four-vessel branching of the arch vessels, typical of right aortic arch with aberrant left subclavian artery. Computed tomography and barium studies of the esophagus demonstrated the retroesophageal course of the aorta. In two patients, obstruction of the thoracic portion of the left subclavian artery resulted in differences in blood pressure and pulse between the arms, supporting the clinical impression of dissecting aortic aneurysm. 相似文献
8.
Lawrence M. Boxt M.D. Philip D. Murray Louis M. Perlmutt Karen M. Monteiro Sammie I. Long Donald P. Denny David C. Levin Donald P. Harrington 《Cardiovascular and interventional radiology》1985,8(2):76-82
Evaluation of intravenous digital subtraction angiography (IV DSA) in patients with abdominal aortic aneurysm was performed
by obtaining catheter aortograms immediately before DSA studies in ten patients. Diagnostic images were obtained in nine of
ten digital subtraction examinations. Although repeat injections were necessary in six DSA and three conventional aortography
cases for adequate imaging of both cephalad and caudal extension of the aneurysm, average contrast dose was 53 cc (62 cc in
standard catheter studies). Renal artery stenosis was diagnosed by DSA in two of three vessels, multiple renal arteries were
demonstrated by both modalities in two cases. Digital subtraction and conventional aortographic findings were proved at surgery.
Intravenous DSA was shown to be useful in the preoperative evaluation of patients with abdominal aortic aneurysm.
This work was supported in part by U.S. Public Health Service Grant No. HL07334. 相似文献
9.
Eskandari MK Resnick SA 《Journal of vascular and interventional radiology : JVIR》2004,15(11):1317-1321
Traditional open repair of thoracic aortic aneurysms remains a high-risk surgical procedure. Thoracic aneurysm stent-graft repair is evolving but has promise as a minimally invasive treatment option. Herein a case is presented of an anastomotic arch aneurysm treated with a custom-made thoracic stent-graft after a left subclavian artery-to-carotid artery transposition. Proximal extension for a type I endoleak necessitated a bailout procedure with a "kissing" left common carotid artery bare stent. 相似文献
10.
Treatment of Acute Aortic Type B Dissection with Stent-Grafts 总被引:3,自引:0,他引:3
Hausegger KA Tiesenhausen K Schedlbauer P Oberwalder P Tauss J Rigler B 《Cardiovascular and interventional radiology》2001,24(5):306-312
Purpose: To evaluate the feasibility of endoluminal stent-grafts in the treatment of acute type B aortic dissections.
Methods: In five patients with acute aortic type B dissections, sealing of the primary intimal tear with an endoluminal stent-graft
was attempted. Indication for treatment was aneurysm formation in two patients and persistent pain in three patients. One
of the latter also had an unstable dissection flap compromising the ostium of the superior mesenteric artery. The distance
from the intimal tear to the left subclavian artery was <0.5 cm in four patients, who had typical type B dissections. In one
patient with an atypical dissection the distance from the primary tear to the left subclavian artery was 4 cm. This patient
had no re-entry tear. Talent tube grafts (World Medical Manufacturing Cooperation, Sunrise, FL, USA) were used in all patients.
Results: Stent-graft insertion with sealing of the primary tear was successful in all patients. The proximal covered portion of the
stent-graft was placed across the left subclavian artery in four patients (1× transposition of the left subclavian artery).
Left arm perfusion was preserved via a subclavian steal phenomenon in the patients in whom the stent-graft covered the orifice
of the left subclavian artery. The only procedural complication we observed was an asymptomatic segmental renal infarction
in one patient. In the thoracic aorta thrombosis of the false aortic lumen occurred in all patients. In one patient the false
lumen of the abdominal aorta thrombosed after 4 weeks; in the other three patients the status of the abdominal aorta remained
unchanged compared with the situation prior to stent-graft insertion. As a late complication formation of a secondary aneurysm
of the thoracic aorta was observed at the distal end of the stent-graft 3 months after the primary intervention. This aneurysm
was treated by coaxial insertion of an additional stent-graft without complications.
Conclusion: Endoluminal treatment of acute type B aortic dissections seems to be an attractive alternative treatment to surgical repair.
Thrombosis of the false lumen of the thoracic aorta can be induced if the primary tear is sealed with a stent-graft. This
could protect the dissected thoracic aorta from delayed rupture. 相似文献
11.
Stéphane Verdeille M.D. Michel Tonnelier Michel A. Ghossain Francis Besse Jean-Noël Buy 《Cardiovascular and interventional radiology》1988,11(6):325-328
An unusual association of agenesis of the left internal carotid artery and coarctation of the aorta is reported. There was
also an aneurysm of the thoracic aorta distal to the coarctation. The subclavian artery was obstructed and revascularization
occurred through the vertebral artery via anastomoses with the occipital artery. An embryological hypothesis for this association
is proposed. 相似文献
12.
目的探讨胸主动脉腔内修复术(TEVAR)治疗Stanford B型主动脉夹层的长期疗效。方法回顾性搜集300例行TEVAR治疗的Stanford B型主动脉夹层患者的临床及影像学资料,分析患者短期(在院/术后30天)及长期死亡率、并发症发生率及主动脉重塑情况。结果技术成功率100%。左锁骨下动脉完全覆盖29例,烟囱支架重建左锁骨下动脉11例,烟囱支架重建左颈总动脉7例。患者在院/术后30天死亡率0.7%(2/300),并发症发生率14%(42/300)。中位随访时间35个月(6~126个月)。1、3、5年累积全因死亡率分别为2.0%、6.7%、12.8%,主动脉夹层相关死亡率分别为1.7%、4.5%、8.4%;晚期并发症发生率14.7%(44/300),胸主动脉段假腔完全血栓化率83.7%(251/300)。结论应用覆膜血管内支架行TEVAR是治疗Stanford B型夹层安全有效的方法,长期疗效令人满意。 相似文献
13.
Aberrant subclavian arteries: cross-sectional imaging findings in infants and children referred for evaluation of extrinsic airway compression 总被引:4,自引:0,他引:4
Donnelly LF Fleck RJ Pacharn P Ziegler MA Fricke BL Cotton RT 《AJR. American journal of roentgenology》2002,178(5):1269-1274
OBJECTIVE: The purpose of our study was to describe patterns of airway compression identified on cross-sectional imaging in infants and children with either right aortic arch and aberrant left subclavian artery or left aortic arch with aberrant right subclavian artery. MATERIALS AND METHODS: Data from MR imaging and CT performed to evaluate pediatric patients for extrinsic airway compression were reviewed for cases that revealed an aberrant right or left subclavian artery. Clinical, endoscopic, and imaging findings in identified cases were reviewed. Recurrent patterns of extrinsic compression were reviewed among cases. RESULTS: Twelve patients with right aortic arch with aberrant left subclavian artery and nine patients with left aortic arch and aberrant right subclavian artery were identified. All 12 with right aortic arch with aberrant left subclavian artery had airway compression shown, with multiple sites or diffuse compression in six. Of these 12 patients, nine had compression at the level of the arch and aberrant subclavian artery (10 had Kommerell's diverticulum), and nine had compression of the distal airway in association with a midline descending aorta. Five of the nine patients with left aortic arch and aberrant right subclavian artery had airway compression shown, all at the level of the arch and aberrant subclavian artery. None of these compressions was associated with either Kommerell's diverticulum or midline descending aorta. CONCLUSION: Both right and left aberrant subclavian arteries can be associated with symptomatic airway compression, but the patterns of compression are different. The airway compression in right aortic arch with aberrant left subclavian artery is often associated with either Kommerell's diverticulum or midline descending aorta, whereas compression associated with left aortic arch and aberrant right subclavian artery is not. 相似文献
14.
An aneurysm of an aberrant right subclavian artery was diagnosed with computed tomography (CT) in a 77-year-old man with an
asymptomatic mediastinal mass at admission. Although CT clearly demonstrated this rare congenital anomaly, further radiologic
study or surgery was not attempted because of the patient's advanced age and lack of symptoms. 相似文献
15.
Motoichiro Takahashi M.D. Satoru Ohba Hiroyuki Hanai Yoshiro Nishimura 《Cardiovascular and interventional radiology》1981,4(2):136-138
A case of congenital subclavian steal caused by a previously unreported aortic arch anomaly was demonstrated by angiography.
The patient was shown to have a right aortic arch with a retroesophageal segment, a stenotic proximal portion of the left
subclavian artery, and a left descending aorta. 相似文献
16.
Ronald Otto Walter S. Tan Dimitrios G. Spigos M.D. 《Cardiovascular and interventional radiology》1986,9(2):90-92
An atherosclerotic aneurysm of the right subclavian artery causing subclavian steal syndrome is described. Complementary information
obtained from digital subtraction angiography and computed tomography helped to establish a correct preoperative diagnosis. 相似文献
17.
Wilfrido R. Castaneda-Zuniga M.D. P. H. Nath C. Zollikofer G. Velasquez O. Valdez-Davila E. Edwards 《Cardiovascular and interventional radiology》1980,3(3):144-149
The radiographic and pathologic features of 13 cases of mycotic aneurysm of the aorta were reviewed retrospectively. In four
cases the mycotic aneurysm was associated with bacterial endocarditis following aortic valve replacement, and in nine cases
it was associated with spontaneous bacterial endocarditis. Postmortem examination revealed that the mycotic aneurysm was most
frequently found in cases with bicuspid aortic valves. In all cases the chest radiograph revealed cardiomegally, usually with
pulmonary vascular congestion. In the six patients in whom the diagnosis was established angiographically, the aneurysm was
manifested by an irregular saccular collection of contrast medium under one of the coronary arteries. Mycotic aneurysms must
be differentiated from other lesions with similar angiographic findings, such as a congenital aneurysm of the sinus of Valsalva,
prolapse of an aortic cusp through a membranous ventricular septal defect, and a congenital aortic-left ventricular tunnel. 相似文献
18.
Ahuva Engel Olga B. Adler M.D. Roni Carmeli 《Cardiovascular and interventional radiology》1989,12(2):92-94
An aneurysm in the subclavian artery is relatively uncommon and a cervical rib as the cause is rare. Such a case is presented
and the pertinent literature is reviewed. The mechanism of aneurysm formation in a normal vessel wall is discussed. 相似文献
19.
目的 分析Behcet病的胸部CT表现,评价其在诊断中的作用.方法 回顾性分析13例有胸部病变的Behcet病的临床病历记录及CT影像资料,所有患者的诊断根据Behcet病国际研究小组诊断标准.结果 13例中3例表现为胸膜下斑片状实变影,3例为双肺弥漫磨玻璃密度影,1例左下叶塌陷伴有右下叶结节影,1例胸膜下孤立结节影,2例双侧少量胸水,2例伴有纵隔淋巴结增大,1例在治疗过程中CT表现为双肺弥漫性粟粒状结节.13例中8例有胸部血管病变,2例为上腔静脉栓塞;1例左锁骨下动脉瘤;1例左下肺动脉瘤伴附壁血栓;1例双下肺动脉瘤及左侧基底动脉瘤;3例右下肺动脉栓塞,其中2例伴有左肺动脉闭塞,1例伴有左侧基底动脉分支动脉瘤.结论 Behcet病的胸部CT表现多种多样,增强CT可显示胸部血管病变如上腔静脉或肺动脉栓塞、肺动脉瘤等,有助于对病变的评价. 相似文献
20.
Congenital abnormality of the aortic arch is a diagnosis made most of the time incidentally in childhood, unless dysphagia
or respiratory disorders occur before. A case of a complex aortic arch anomaly with an aneurysm of the right subclavian artery
presenting as an isolated Horner's syndrome in an adult is reported herein. Magnetic resonance imaging led to this very unusual
diagnosis.
Received: 17 March 1999; Revised: 15 July 1999; Accepted: 13 August 1999 相似文献