共查询到20条相似文献,搜索用时 31 毫秒
1.
Anne L. Long M.D. Jean C. Gaux Alain C. Raynaud Jean M. Faintuch Jean Y. Pagny Pascal Lacombe Jean N. Fiessinger John Y. Relland Bernard M. Beyssen 《Cardiovascular and interventional radiology》1993,16(4):203-208
From March 1990 to May 1991, arterial stents were placed in seven patients because of a tight stenosis (five patients) or
a total chronic occlusion (two patients) located in the infrarenal aorta. In one case, the aortic occlusion extended to both
common iliac arteries. After balloon dilatation, aortic stents were successfully positioned in all cases. Bilateral common
iliac recanalization and stent placement were performed in one case. No complications occurred in any of the patients. Follow-up
data were derived from clinical assessments and angiographic results. After a 15.1-month mean follow-up period (range 12–24
months), the seven aortic stents remained patent. Three iliac artery procedures were performed in two of the patients as well.
Claudication recurred in three of the seven patients which was related to a common iliac occlusion (one case) or distal progression
of atherosclerosis (two cases). Aortic stents seem to be suitable for treating failed angioplasty of aortic lesions but the
procedure remains technically difficult when there is associated severe atherosclerosis of the proximal common iliac arteries.
Nevertheless, considering the morbidity rate (0%) and the patency rate in this series, this technique could become an alternative
to surgical treatment for infrarenal aortic occlusive lesions. 相似文献
2.
Iozzelli A D'Orta G Aliprandi A Secchi F Di Leo G Sardanelli F 《European journal of radiology》2009,72(3):489-493
To test true-fast imaging with steady-state precession (true-FISP) added to gadolinium-based MR angiography (Gd-MRA) for imaging abdominal aorta and major abdominal vessels, 35 consecutive patients (age 67 ± 11 years) with known or suspected abdominal and/or peripheral vascular disease were studied with sagittal and axial 2D true-FISP during free breathing and coronal 3D fast low-angle shot (FLASH) Gd-MRA (breath-holding, 0.2 mmol/kg of Gd-DOTA at 2 ml/s). We evaluated: suprarenal aorta, celiac trunk, superior mesenteric artery, right renal artery, left renal artery, infrarenal aorta, inferior mesenteric artery, aortic bifurcation/common iliac arteries, lumbar arteries and aortic atheromasia. The possible presence of accessory renal arteries, collateral vasculature and vascular prosthesis/stent was evaluated. A quality four-point score was assigned to each item on both sequences, from 0 (not visible) to 3 (good-to-excellent image quality) and Wilcoxon test was used. Main diagnoses resulted: normal or atheromasic aorta (n = 25); aortic aneurysm (n = 2); patent aorto-iliac surgical prosthesis (n = 2); patent vascular iliac stent (n = 2); aneurysm of iliac artery (n = 1); patent aortic endovascular prosthesis (n = 1); patent aorto-femural bypass (n = 1) and aorto-iliac surgical prosthesis endoleak (n = 1). We also found three patients with accessory renal arteries, two with collateral circulation, and three with surgical aorto-iliac prosthesis. The score of true-FISP (25.9 ± 4.1, median 27) was significantly higher (p = 0.003) than that of Gd-MRA (23.9 ± 3.6, median 24). True-FISP was superior for visualizing inferior mesenteric artery (score 2.5 ± 1.1 vs. 1.0 ± 1.4; p < 0.001) and atheromasic plaques (2.5 ± 1.1 vs. 1.2 ± 1.1; p < 0.001). One collateral vasculature was demonstrated only with Gd-MRA. Summarizing, true-FISP is a power and fast non-breath-hold sequence to be added to Gd-MRA, obtaining an information increase. 相似文献
3.
4.
A. Ferko A. Krajima B. Jon M. Leško Z. Vobořil J. Žižka P. Eliás 《European radiology》1997,7(5):703-707
Endoluminal transfermoral repair of an abdominal aortic aneurysm by a stent graft placement requires a segment of the nondilated
infrarenal aorta of at least 15 mm long for safe stent graft attachment. The possibility of endoluminal treatment of a juxtarenal
abdominal aortic aneurysm with partially covered spiral Z stent was assessed in experiment and in three clinical cases. In
the experiment, the noncovered spiral Z stent was placed into the abdominal aorta, across the origins of renal arteries and
mesenteric arteries, in six dogs. In the clinical cases, a partially covered stent graft was attached in 3 patients with the
juxtarenal abdominal aortic aneurysm (of the group of 12 patients with abdominal aortic aneurysm). The stent grafts were attached
with proximal uncovered parts across the origins of the renal arteries. In experiment, the renal artery occlusions or stenoses
were not observed 36 months after stent placement, and in clinic 3 patients with the juxtarenal aortic aneurysm were successfully
treated by stent graft placement. There were no signs of flow impairment into the renal arteries 14 months after stent graft
implantation. This approach can possibly expand the indications for endoluminal grafting in the treatment of juxtarenal aortic
aneurysms in patients who are at high risk for surgery. 相似文献
5.
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
6.
R A Benedikt J S Jelinek P S Schaefer F Edwards V Ghaed 《Journal of magnetic resonance imaging : JMRI》1991,1(4):485-486
Reports of aneurysms of the subclavian artery in both normal and anomalous aortic arches have been rare. The authors describe a patient with a right-side aortic arch and an aneurysm of the aberrant left subclavian artery, which, to the authors' knowledge, is a previously unreported association. At presentation, the aneurysm appeared as a calcified left superior mediastinal mass. Magnetic resonance imaging enabled preoperative diagnosis and guided surgical planning. 相似文献
7.
Steingruber IE Czermak BV Chemelli A Glodny B Bonatti J Jaschke W Waldenberger P Rieger M Neuhauser B 《European radiology》2007,17(7):1727-1737
The aim of this retrospective study was to evaluate mid- and long-term results of endovascular stent-graft placement for emergency
repair of acute traumatic thoracic aortic rupture. From 1996 through 2005, 22 consecutive patients (mean age: 38.7 years)
underwent endovascular repair of acute traumatic thoracic aortic rupture located at the aortic isthmus in most cases. All
patients were at high surgical risk due to severe associated injuries. The endografts were inserted via femoral or iliac artery
access under fluoroscopic guidance. Follow-up was performed postinterventionally, at 6 and 12 months and yearly thereafter,
and included clinical examination and computed tomography (CT) scans. Technical and clinical success rates were 86.3%. Mean
follow-up was 31.7 months. Three patients developed early type I endoleak due to the inability of the rigid graft to adapt
to the curved aortic contour. In two of them conversion to open surgery was necessary. One patient had late type I endoleak
and died. No other complications were observed. The outcome was successful in most patients. The mid- and long-term results
of our current study are promising. However, early type I endoleak represents a problem, especially in adolescent patients
with a marked curvature of the aortic arch. 相似文献
8.
Sueyoshi E Sakamoto I Uetani M Matsuoka Y Suenaga E 《Cardiovascular and interventional radiology》2007,30(2):321-323
Mediastinal hematoma extending along the pulmonary artery is a rare complication of Stanford type A classic (double-barreled) aortic dissection. Rupture from the posterior aspect of the aortic root penetrates the shared adventitia of the aorta and pulmonary artery. From this location, hematoma can spread along the adventitial planes of the pulmonary arteries out into the lungs. We report a case of ruptured intramural hematoma of the aorta (IMH) extending along the pulmonary artery. To our knowledge, this finding in patients with IMH has not been reported in the literature. 相似文献
9.
Christopher T. Shen M. K. Razavi Charles P. Semba Michael D. Dake 《Emergency radiology》1999,6(4):197-203
Purpose: To report our experience with stent-graft treatment of acute aortic injuries. Materials and methods: Emergent stent-graft placement was considered in patients with acute aortic rupture or injury who were deemed to be high-risk
candidates for surgery. After medical stabilization, patients were evaluated for suitability for endovascular interventions.
Anatomic criteria for stent-grafting included: (1) contained ruptures of the thoracic aorta located distal to the left subclavian
artery and above the celiac axis, and (2) a proximal and distal neck of ≥ 15 mm in length and ≤ 40 mm in diameter. Stent-grafts
consisted of a modified Z-stent endoskeleton covered with woven polyester vascular graft material. All devices were placed
under general endotracheal anesthesia. A transfemoral approach was utilized if the iliofemoral artery diameter was ≥ 8 mm.
For iliofemoral diameters < 8 mm, the catheters were inserted directly into the infrarenal aorta after a retroperitoneal exposure.
Patient follow-up consisted of angiography and spiral CT scan prior to discharge from the hospital. Subsequent spiral CT studies
were performed at 6 and 12 months, and at 1-year intervals thereafter. Results: Thirteen patients (11 men and 2 women) with a mean age of 60 years (range 34–81 years) underwent emergent placement of thoracic
stent-grafts for acute aneurysmal rupture (n = 8), traumatic transection (n = 3), or tumor and abscess erosions (n = 2). The stent-grafts were deployed successfully in all cases and there were no cases of embolization, paraplegia, or stent-graft
migration. No patient required surgical conversion. The average stent-graft dimension was 34 mm in diameter (range 24–38 mm)
by 15.8 cm in length (range 5.0–17.5 cm). No patient with traumatic aortic injury was excluded on the basis of anatomic criteria.
Two patients died within 1 month of the procedure, one of ventricular rupture and the other of cardiac arrest on day 28 after
an uneventful hospital course for a ruptured aneurysm. Conclusion: The preliminary experience from our series demonstrates that aortic stent-grafting for traumatic aortic injury is technically
feasible and can be used to treat thoracic aortic rupture in patients at high risk for standard operative therapy. 相似文献
10.
Roland Dorffner Siegfried Thurnher Rupert Prokesch Soraya Youssefzadeh Thomas Hölzenbein Johannes Lammer 《Cardiovascular and interventional radiology》1998,21(2):179-182
We evaluated the vascular territory of accessory renal arteries in cases where the vessel might be overlapped by an aortic
stent-graft. Spiral CT during selective accessory renal artery angiography was performed in four patients with abdominal aortic
aneurysms (including one with a horseshoe kidney). The volume of the vascular territory of each renal artery was measured
using a software program provided by the CT unit manufacturer. The supernumerary renal arteries perfused 32%, 37%, 15%, and
16% of the total renal mass, respectively. In two patients, stent-grafts were implanted, which resulted in occlusion of the
supernumerary renal artery. The volume of the renal infarction was equal to the volume perfused by the artery as calculated
before implantation of the stent-graft.
The method proposed is accurate for estimating the size of the expected renal infarction. It might help to determine whether
placement of a stent-graft is acceptable. 相似文献
11.
Stecker MS Lalka SG Agarwal DM Johnson MS Willing SJ 《Journal of vascular and interventional radiology : JVIR》2002,13(4):413-417
In this article, a patient with extensive cerebrovascular disease who had previously undergone bilateral carotid endarterectomy and subsequent operative revision on the left side is described. The patient developed critical restenosis at the cephalic end of the previous left patch angioplasty as well as a severe stenosis of the left common carotid artery origin, which originated from a bovine aortic arch configuration. His right common and internal carotid arteries had become occluded. Endovascular treatment with two metallic stents was successfully performed through a surgical cutdown on the immediate supraclavicular portion of the left common carotid artery to establish antegrade and subsequently retrograde vascular access. 相似文献
12.
Maspes F Gandini R Pocek M Mazzoleni C Fiaschetti V Marchetti Ascoli Pistolese GR Simonetti G 《La Radiologia medica》1999,98(4):275-282
PURPOSE: To investigate different clinical applications of gadolinium-enhanced MR angiography (Gd MRA) using three-dimensional breath-hold GE sequences, without bolus time calculation, in patients with vascular diseases. MATERIAL AND METHODS: Forty-seven patients were examined (49 studies in all). Eleven of them had an abdominal aortic aneurysm, 6 surgical bypass, 7 renal artery stenosis, 3 aortoiliac Wallstent, 7 aortic stent-graft; 11 patients had a suspected condition in the thoracic aorta and pulmonary arteries, 1 had subclavian artery stenosis and 1 suspected axillary artery compression. All patients were submitted to breath-hold Gd MRA, after 30-40 mL Gd, with a 1.5 T magnet (Gyroscan ACS-NT, Philips, The Netherlands) and a standard body coil. The GE sequences were acquired with TR = 8.8, TE = 2.7, FA = 60 degrees, matrix = 163 x 512, with 28 seconds acquisition time. Digital subtraction angiography and intraoperative findings were the reference standards to evaluate the results. RESULTS: Thoracopulmonary district: metastatic compression of axillary vessels was found in 1 breast cancer patient; the true and the false lumens and the intimal flap were identified in 2 patients with chronic aortic dissection (Stanford A), and graft patency and complete resolution of the aortic dissection was seen in the patient operated on for acute aortic dissection (Stanford A). The thrombus, lumen, extent and diameter were studied in 2 patients with thoracic aortic aneurysms. Subclavian artery stenosis was demonstrated in 1 patient, which was treated with transluminal angioplasty and stenting. The other 6 patients had normal findings. Abdominal aortic aneurysms (AAA): as for disease extent, breath-hold Gd MRA had 100% sensitivity and specificity compared with surgical findings. Juxtarenal aneurysm extent, which had been missed at DSA, was detected in 1 patient and then confirmed at surgery. Stenosis: comparing DSA and MRA findings in the whole series of patients we had 97.4% agreement (155/159 arteries), that is 76.4% (13/17) arteries) considering only stenoses > 50%. Breath-hold Gd MRA sensitivity and specificity were 100 and 87.5%, respectively, in our 28 stenoses. Bypass, aortoiliac stent, vascular endograft: patency was demonstrated in all the 6 surgical bypass patients, and there was agreement with color Doppler findings in 5 of 6. Breath-hold Gd MRA seems to have no possible applications in the follow-up of percutaneously implanted iliac stents, but we had excellent findings about patency and position of nichel-titanium endografts used for AAA treatment. CONCLUSIONS: We optimized breath-hold 3D MRA without bolus transit time calculation and with high-dose Gd in different clinical vascular conditions. In our opinion, 3D GE sequences can replace DSA in selected cases, providing a fast, accurate and noninvasive examination. 相似文献
13.
François Pinet Jean Claude Froment Marcel Guillot Yves Gourdol Pascale Meyer Robert Loire Paul Touboul Jean-Pierre Delahaye Albert Biron Philippe Messy 《Cardiovascular and interventional radiology》1984,7(6):257-266
A total of 191 acute aortic dissections were examined to define prognostic factors for surgical intervention. Overall survival
rate reached 40% in the 94 patients operated upon and 8% in the 97 patients not operated upon. Among the 122 patients with
involved ascending aorta, survival rate was 2% in the 42 nonoperated patients versus 42% in 80 patients undergoing surgery.
Since 1977, overall survival rate has reached 60% in the surgical group (21 of 35 patients and 20% in the nonsurgical group
(5 of 25 patients). Factors that showed a significant correlation with postoperative death include: (1) persistent shock;
(2) persistent anuria; (3) persistent neurologic deficit; (4) diffuse intravascular coagulation; and (5) involvement of either
the celiac trunk, superior mesenteric artery. or both renal arteries at angiography. With the exception of those patients
exhibiting any of these high-risk factors, emergency surgical treatment is recommended for all dissections that involve the
ascending aorta. 相似文献
14.
Donald P. Harrington M.D. Teresa Brennan Jacob P. Varghese 《Cardiovascular and interventional radiology》1981,4(1):24-26
Isolation of the left innominate artery and right aortic arch, a rare variant of right aortic arch anomalies, was diagnosed
in a four-year-old boy with other congenital cardiac anomalies. Isolation of vessels from the aortic arch is predicted from
the primitive double aortic arch model of Edwards. In this patient there was no evidence of a vascular ring or of a significant
subclavian steal syndrome. 相似文献
15.
James L. Fleckenstein M.D. Steven M. Schultz Rudolph H. Miller 《Cardiovascular and interventional radiology》1987,10(4):194-197
The victim of a high speed motor vehicle accident sustained an ascending aortic laceration as well as avulsion of the left
subclavian artery. Initial management of the tears was conservative. The case is typical of “atypical” aortic arch tears except
that the patient survived without emergent surgery. Serial aortography proved useful in assessing stability of the tears,
providing opportunity to observe the natural history of these injuries angiographically. The distribution of aortic arch injuries
following blunt trauma is reviewed. 相似文献
16.
Stanford B型主动脉夹层动脉瘤腔内隔绝术后截瘫的预防对策 总被引:2,自引:1,他引:1
目的 探讨Stanford B型胸主动脉夹层动脉瘤(TAD)腔内隔绝术(EVE)后截瘫或轻瘫的综合防治措施。方法 回顾在1998年至2001年实施的116例TAD EVE。对于可能发生截瘫的高危患者,术后常规给予地塞米松。结果 包括接受脊髓动脉造影者在内,成功释放并固定移植物的115例中,均无截瘫或轻瘫发生。结论 EVE虽避免了长时间主动脉阻断,但仍可因封闭肋间动脉造成脊髓的严重缺血,包括选择性脊髓动脉造影、糖皮质激素在内的综合性预防措施能减小发生截瘫/轻瘫的危险,而选择适当长度的移植物是其关键。 相似文献
17.
John Slavotinek Simon W. Kendall Christopher D. R. Flower M.D. Adrian K. Dixon Francis C. Wells Stephen R. Large 《Cardiovascular and interventional radiology》1993,16(5):293-296
A patient with persistent chronic dissection proximal to an aortic interposition graft for repair of a type A dissection prompted
us to review the computed tomographic (CT) findings in 14 other such patients 5–47 months after surgery. No other case of
proximal aortic dissection was identified although dilatation of the aortic root proximal to the graft was present in 8 patients
(57%). Persistent dissection distal to the graft in 11 patients (79%) was in keeping with that reported by other workers.
Chronic dissection proximal to the surgical repair of a dissection seems a rare although important complication 相似文献
18.
《Radiologia》2016,58(3):235-238
This case presentation is about an 88 years-old male patient with previous endovascular aortic aneurysm repairment history and aortic endoleak type II (EL2). The direct lumbar artery catheterization was considered an alternative to solve EL2, associated with aortic endovascular prosthesis and due to an incomplete sealing or exclusion of the aneurysmal sac or a vascular segment demonstrated by imaging studies, when other treatment alternative failed (transarterial embolization) to control the aneurysm growing. Performing translumbar approach was decided by puncturing the artery lumbar (L4) left, previously the lumbar arteries (L4) were evaluated in the abdominal CT arterial phase to guide a puncture/access under flouroscopy control. Diagnostic angiogram clearly demonstrated the median sacral and right lumbar arteries inflow into the aneurysm sac. Transcatheter embolization with fibered platinum microcoils was performed of the median sacral artery and lumbar left and right arteries (L4), showing satisfactory endoleak devascularization. 相似文献
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20.
Sixty-six iliac arteries in 45 patients, 25 male and 20 female, were treated with percutaneous transluminal angioplasty (PTA) for atherosclerotic occlusive disease. Of 103 lesions dilated, 51 were in common iliac and 51 in external iliac arteries. While iliac artery disease was the primary lesion in 18 patients, eight of whom had total occlusion, 27 patients had additional femoropopliteal disease. An overall primary success rate of 84% in dilatation of the stenotic lesions, and 33% in recanalization of totally occluded iliac arteries was achieved. In 12 patients, a prescheduled aortic bifurcation graft was cancelled. In one patient, in addition to recanalization of the occluded common iliac artery, the stenotic distal aorta was also successfully dilated. Angioplasty was unsuccessful in 12 patients. There were only three severe complications requiring surgical assistance. To date, less than 2 years, there has been a patency rate of 100%. Transluminal angioplasty is the treatment of choice for single stenotic lesions of the iliac arteries. Lack of calcification is not an absolute guarantee of success, but a favorable factor. 相似文献