DSA 在主动脉夹层动脉瘤腔内隔绝术中的价值

为探讨DSA在腔内隔绝术(EVGE)治疗胸主动脉夹层动脉瘤(TAD)中的应用价值,回顾分析了1998年以来DSA监控下进行的32例EVGE操作,即通过股动脉小切口,以导管系统将支架-人造血管复合体送到裂口处,将裂口封闭.术中DSA裂口发现率为100%,发现4例内漏并在其监控下进行了有效处理.表明DSA可实时、全程监控腔内隔绝术操作,在术前术中发挥测量、定位、即时评估、帮助手术方案决策、发现手术相关并发症以及在其监控下纠正并发症的作用,其视野宽阔,显影清晰,获得参照数据多,使用方便,相关并发症少,是进行EVGE的基本条件.

THE VALUE OF DSA IN ENDOVASCULAR GRAFT EXCLUSION FOR DISSECTING THORACIC AORTIC ANEURYSMS

In order to evaluate digital subtraction angiography(DSA) in the management of Endovascular Graft Exclusion (EVGE) for dissecting thoracic aortic aneurysms,the operation procedures and results in 32 cases of EVGE were retrospectively analysed. The stent grafts were sent to the segment where the tears were located through the incision on the common femoral artery. After the deployment, the tears were sealed. Intraoperatively, 100% of the tears were revealed by DSA, and 4 endoleaks were also detected and managed effectively. The value of DSA in preoperative evaluation, choice of operative procedure, intraoperative monitoring, success ratio evaluation, complication prevention and management was determined. It is concluded that DSA can monitor EVGE on real time and throughout the operation. It can meet the needs of measuring, locating, evaluating thoracic aortic aneurym and deciding its operation,as well as detecting and controlling its complications. Moreover, it provides a large visual field and operating space, and is a high valuable monitoring method for EVGE.