摘要
目的分析我科发现的主动脉弓类型与主动脉弓分支变异情况,复习这些解剖学变异对神经介入影响的文献。方法回顾性分析340例主动脉弓数字减影血管造影(DSA),应用Photoshop分别测量颈总动脉内径、头臂干开口至主动脉弓顶垂直距离,进行分型。并统计主动脉弓分支变异情况。结果340例患者中,3种主动脉弓类型中:Ⅰ型45.9%(156/340),Ⅱ型26.7%(91/340),Ⅲ型27.4%(93/340)。青年组(≤44岁)90例,Ⅰ型72例,Ⅱ型12例,Ⅲ型6例,其中30岁以下患者16例均为Ⅰ型;中年组(45～59岁)110例,Ⅰ型52例,Ⅱ型34例,Ⅲ型24例;老年组(≥60岁)140例,Ⅰ型32例,Ⅱ型45例,Ⅲ型63例。主动脉弓分支变异16.5%(56/340):LCCA与BCT共干、LCCA发自BCT各占5.3%(18/340);其次为LVA第三支发自弓3.8%(13/340),LSCA发自Kommerell’s憩室2例(0.6%)。结论神经介入医生应高度注意弓上分支变异、迂曲与复杂主动脉弓类型。
Objective To analyze digital subtraction angiography （DSA） of aortic arch（AA） types and the variations /lesions of its major branches in patients with cerebral disease. Literature has been reviewed to analyze the variations’clinical implications. Methods From 2007 to 2008,340 inpatients,the average age of （54. 25 ±14. 67） years,included 235 males and 105 females in our hospital,accepted the routine aortic arch angiography. The aortic arch types and the common variation types of aortic arch and its branches were analyzed and summarized on the basis of these data. Result Aortic arch patterns changed with age. There was various variation and lesions occurred to the branches of aortic arch. In 340 patients there were 45.9%（154/340） in typeⅠarch,type 26.7%（91/340）in typeⅡarch,27.4%（93/340）c in type Ⅲ arch. In the aged group（≥60 years）140 cases,typeⅠ～Ⅲ 32,45,63,respectively. In middle aged group（45～59 years）110 cases,typeⅠ～Ⅲ 52,34,24,respectively. And young group （≤44 years） 90 cases,typeⅠ～Ⅲ 72,12,6,respectively. Especially,all 16 patients of 30 years group were typeⅠ. The variation at the major branches of aortic arch,among which,the incidence rate of variation at the brachiocephalic trunk （BCT ） and left common artery （LCCA） and LCCA from the BCT were 5.3%（18/340） respectively,left vertebral artery （LVA） was the 3rd branch from the arch 3.8%（13/340）, the origin of an aberrant left subclavian artery（LSCA） arising from Kommerell’s diverticulum. 0.6% （2/340）. Conclusion The neurointervention doctor should carefully evaluated the patient who had complex aortic arch and/or aortic arch branches variation.
出处
《当代医学》
2010年第11期136-138,共3页
Contemporary Medicine
