Debakey III型主动脉夹层腔内隔绝术后近期CT评估及价值

目的　探讨DebakeyIII型主动脉夹层进行腔内隔绝术 (EVE)后CT评估的方法及价值。 方法　 5 1例De bakeyIII型主动脉夹层患者接受了EVE手术治疗。主要检查内容为移植物的形态、位置 ;移植物内的血流通畅度 ;有无内漏及夹层变化情况。结果　术后近期CT所见 :1例术后 7天CTA检查发现移植物中段少量内漏。 4例于术后 7天发现假腔血栓化不彻底 ,有远端血液反流入假腔。 1例移植物失去正常形态 ,但血流通畅 ,未处理。其余均未发现真腔外异常血流影像。结论　主动脉夹层EVE术后CT评估具有图像重建方式多样、提供的信息量大、可准确测量、图像直观易理解、成像清晰、可观察周围组织、易检出并发症等优点 ,应作为首选的术后评估方法。

Significance of Postoperative Evaluation by CT after Endovascular Exclusion for Debakey Type III Aortic Dissection

Purpose To evaluate the significance of postoperative detection by CT after endovascular exclusion for Debakey type III aortic dissection. Methods Fifty-one consecutive patients with Debakey type III aortic dissection underwent endovascular stent-graft exclusion. The figure and position of the graft, the patency in the lumen, the existents of endoleaks and the change of the dissection were evaluated. Results An endoleak was revealed from the mid-portion of the graft by CTA seven days after procedure. Incomplete thrombosis in the false lumen was detected in four cases, and there were reflux from distal into the false lumen. Frame alteration of the stent was revealed in one case, but the patency maintained. No other abnormality was revealed. Conclusion The method of CT evaluation has the characteristics of multiple reconstruction ways, more information, accurate, be easy understanding, clear images, peri-vessel tissue can be revealed, complications be easily detected. It can be used as the first-choice method in post-operation evaluation.