DSA检测主动脉弓形态及分支变异

目的应用DSA技术评估主动脉形态及其分支变异。方法回顾性分析4272例接受主动脉弓及全脑血管DSA患者的DSA资料,评估主动脉弓形态及分支变异的发生率。结果 4272例患者中主动脉弓形态及分支正常3925例(3925/4272,91.88%),主动脉弓形态及分支变异347例(347/4272,8.12%)。变异类型:左颈总动脉(LCCA)与头臂干(BT)共干起自主动脉弓(175/4272,4.10%);左椎动脉(LVA)直接起自于主动脉弓LCCA与LSA之间(97/4272,2.27%);右颈总动脉(RCCA)直接发自主动脉弓伴迷走右锁骨下动脉(RSA)(35/4272,0.82%);RCCA、LCCA、LSA直接起自主动脉弓,迷走RSA起自降主动脉(10/4272,0.23%);RCCA、LSA直接起自主动脉弓,RSA与LCCA共干起自主动脉弓,RVA起自RCCA(4/4272,0.10%);右椎动脉双起源于RSA(4例/4272,0.10%);RVA起自右侧颈内动脉(4/4272,0.10%);弓上自右向左发出RCCA、LCCA、LSA、RSA,迷走RSA,LVA缺如,伴原始三叉动脉(4/4272,0.10%);镜像型右位主动脉弓(13/4272,0.30%);右位主动脉弓,LSA起自弓上Kommecell憩室(1/4272,0.02%)。结论通过DSA评估主动脉弓形态类型及分支的变异情况对介入诊断及治疗和某些胸部手术具有重要指导意义。关键词]血管造影术,数字减影;主动脉,胸;解剖学变异

DSA in detection of morphology and branches variation of aortic arch

Objective To investigate the variation of morphology and branches of the aortic arch with DSA. Methods DSA data of 4272 patients received aortic arch and cerebral DSA were retrospectively analyzed, and the variation prevalence of the aortic arch and associated vessel was assessed. Results Among the patients, 3925 (3925/4272,91.88%) was normal. There were 347 patients (347/4272, 8.12%) were identified with variation of morphology and branches of the aortic arch, including followed type: Brachiocephalic trunk (BT) and left common carotid artery (LCCA) having a common trunk arising from the aortic arch (175/4272, 4.10%). Left vertebral artery (LVA) originated from the aortic arch between LCCA and left subclavian artery (LSA, 97/4272, 2.27%). RCCA originated directly from the aortic arch with aberrant right subclavian artery (RSA, 35/4272, 0.82%). RCCA, LCCA, LSA originated from the aortic arch and RSA originated aorta descendens (10/4272, 0.23%). RCCA, LSA originated directly from aortic arch, RSA and LSA had a common trunk arising from aortic arch, and RVA originated directly from RCCA (4/4272, 0.10%). The duplicitous origin of RVA originated from RSA (4/4272, 0.10%). RVA directly originated from right internal carotid artery (4/4272, 0.10%). From right to left RCCA, LCCA, LSA, RSA originated aortic arch, aberration RSA and LVA was absence combined with the persistence primitive trigeminal artery (4/4272, 0.10%). The right aortic arch (13/4272, 0.30%), and the right aortic arch and LSA originated from Kommecell diverticulum (1/4272, 0.02%). Conclusion Assessment of variation of the morphology and branches of the aortic arch with DSA has important guiding significance for vascular interventional therapy and some thoracic surgeries.