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在患有腹腔大动脉动脉瘤的患者中右侧大动脉扭曲
Anirudh Chandrashekar1, Luis Leon2, Lachlan Smith1
1Stony Brook Medicine, Stony Brook, NY, USA.
Annals of vascular surgery
|March 19, 2025
概括
腹腔大动脉动脉瘤 (AAA) 患者表现出显著的大动脉扭动,与对照人群相比,下层中枢动脉 (IMA) 角度向右移动. 这种扭动可能与动脉瘤内的螺旋式血流模式有关.
科学领域:
- 血管外科 血管外科
- 生物医学工程 生物医学工程
- 医疗成像医学成像
背景情况:
- 腹腔大动脉动脉瘤 (AAA) 的血液动力学变化可以影响几何,内血栓 (ILT) 沉积和进展.
- 大动脉扭动是一种几何偏差,在AAA中观察到,但缺乏正式的手术前评估.
- 这项研究调查了在患有和没有AAA的患者中大动脉扭动的程度和方向性.
研究的目的:
- 量化和比较腹腔大动脉动脉瘤和没有腹腔大动脉动脉瘤的患者之间的大动脉扭动.
- 评估大动脉扭转与患者人口统计,动脉瘤大小和内血栓特征之间的关系.
主要方法:
- 一项回顾性队列研究,涉及370名AAA患者和120名非动脉瘤对照.
- 大动脉扭动的评估是使用下层中枢动脉 (IMA) 角度,相对于前后 (AP) 轴进行测量.
- 收集的数据包括患者年龄,性别,最大下大动脉/AAA直径 (DMax),以及ILT的存在/百分比.
主要成果:
- AAA患者 (n=370) 的IMA中位角为17.0°,比对照组更接近AP轴 (n=120,38.5°,p <0.001).
- 内血栓 (ILT) 的存在,百分比和分类对IMA出口角度的影响微不足道.
- AAA队列特征:年龄74岁,88%男性,DMax50.1毫米;ILT存在于65%.
结论:
- 与非动脉瘤患者相比,腹腔大动脉动脉瘤患者对右侧大动脉扭动有显著的偏好.
- 潜在的病理生理学可能涉及右侧螺旋式血液流动模式在扩张动脉囊.
- 这一发现为未来研究大动脉扭转在AAA发展和进展中的作用奠定了基础.
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