大动脉炎的血管造影诊断与介入治疗

目的 :探讨大动脉炎的血管造影诊断与介入治疗价值。方法 :大动脉炎 38例 ,男性 11例 ,女性 2 7例 ,年龄 8～ 5 4岁 ,平均 (30 5± 18)岁 ,均行血管造影检查。由 2名有经验的介入放射学医师按双盲法对其血管造影及介入治疗资料进行回顾性分析 ,然后共同讨论并达成一致意见。结果 :38例中 ,经血管造影按Lupi Herrera的综合分型法属Ⅰ型者 11例 ,Ⅱ型 15例 ,Ⅲ型 7例 ,Ⅳ型 5例。主要受累的动脉包括锁骨下动脉 2 0例 (5 2 6 % ) ,腹主动脉 15例 (39 5 % ) ,肾动脉 4例 (36 8% ) ,胸主动脉 10例(2 6 3% ) ,颈动脉 9例 (2 3 7% ) ,髂动脉 9例 (2 3 7% ) ,腋动脉 7例 (18 4 % ) ,肠系膜上动脉 4例 (10 5 % ) ,冠状动脉 3例 (7 9% ) ,肺动脉 3例 (7 9% )等。 2 2例行经皮腔内血管成形术和 12例行狭窄段支架置入术均获成功。结论 :血管造影有利于大动脉炎的临床诊断与指导治疗 ,血管内介入治疗是一种微创的疗效可靠的治疗手段。

Angiographic diagnosis and interventional therapy for Takayasu arteritis

Objective: To explore the value of angiographic diagnosis and interventional therapy for Takayasu arteritis. Method: Thirty-eight patients with Takayasu Arteritis(TA)(11 men,27 woman;aged 8～54;average age,30.5±18) underwent angiography were analyzed retrospectively.The angiographic appearances in all of the patients were observed dynamically in a double blind method by two experienced radiologists together and formed a consensus interpretation.Result:According to the classification of Lupi-Herrea type,the type Ⅰ was found in 11 cases,the type Ⅱ in 15,the type Ⅲ in 7 and the type Ⅳ in 5 cases by angiography in the 38 patients.Among 38 patients,subclavian artery was involved in 20 cases(52.6%),the abdominal aorta in 15 cases(39.5%),the renal artery in 14 cases(36.8%),thoracic aorta in 10 cases(26.3%),carotid artery in 9 cases (23.7%),iliac artery in 9 cases(23.7%),axillary artery in 7 cases(18.4%),superior mesenteric artery in 4 cases(10.5%),coronary artery in 3 cases(7.9%),pulmonary artery in 3 cases(7.9%),and so on.Percutaneous transluminal angioplasty was performed in 22 cases and the stent placement was managed in 12 cases successfully.Conclusion:Angiography is one of the ideal and reliable methods used to diagnose and to guide the interventional treatment for TA,and the interventional intravascular treatment is a micro-traumatic and effective way for TA.