Application Of Simultaneous Imaging Of Ureter And Abdominal Aorta In The Operation Of Abdominal Aortic Aneurysm

Objective(s):To explore the adjustment of relevant parameters during clinical application of simultaneous ureteral and abdominal aorta imaging technology,and whether the application of this technology can provide clinicians with a good anatomical relationship between the abdominal aorta,ureter,and surrounding tissues before surgery,determine whether there is preoperative ureteral stenosis,prevent possible ureteral injury during open surgery,and reduce the occurrence of ureteral stenosis and obstruction after EVAR and open surgery,improve patient prognosis.Methods:From August 2021 to February 2023,a total of 100 patients with abdominal aortic aneurysm underwent surgical treatment in the cardiovascular surgery department of XX Hospital of Kunming Medical University,including 15 female patients(15.00%)and 85 male patients(85.00%).The minimum age of all patients is 50 years old,the maximum age is 90 years old,and the average age is(68.13 ± 8.42)years old.59 cases(59.00%)had a history of smoking and 79 cases(79.00%)had hypertension.The minimum hospitalization period is 4 days,and the maximum hospitalization period is 14 days.Among them,80 patients(80.00%)underwent EVAR treatment and 20 patients(20.00%)underwent open surgery.After admission,all patients undergoing surgical treatment underwent simultaneous imaging of the ureter and abdominal aorta to determine whether there was ureteral stenosis or obstruction,and whether there was adhesion in the abdominal aorta,ureter,and surrounding tissues.The accuracy of preoperative examination was determined based on the comparison between intraoperative exploration and creatinine elevation after EVAR surgery,After surgery,simultaneous imaging of the ureter and abdominal aorta was performed again to assess whether the patient had ureteral stenosis or injury after surgery,and the time for pre injection of contrast agent before CT scanning was evaluated based on the degree of ureteral imaging during different preoperative and postoperative examinations.Results: All patients with abdominal aortic aneurysm underwent simultaneous imaging examination of the ureter and abdominal aorta before surgery,and EVAR or open surgery was selected based on factors such as the condition of the aneurysm,the general condition of the patient,and the wishes of the patient and their families.A total of 27 patients were found to have adhesions of the abdominal aorta,ureter,and surrounding tissues during the simultaneous imaging examination of the ureter and abdominal aorta before surgery.Among them,7 patients underwent open surgery,and20 patients underwent EVAR treatment.After statistical analysis,the effects of gender,age,hypertension,and smoking history on the examination results were excluded.According to the comparison of intraoperative exploration and creatinine elevation after EVAR in open surgery,it was found that there was no significant difference in the detection of ureteral abnormalities compared to simultaneous imaging of the ureter and abdominal aorta(P>0.05).Based on the preoperative and postoperative ureteral and abdominal aorta imaging findings of patients undergoing simultaneous imaging,CTA examination 4-5 minutes after the first injection of contrast agent for ureteral imaging is more satisfactory,with high reference value for images,and more convenient clinical application.Conclusion(s): The application of simultaneous ureteral and abdominal aorta imaging technology can provide clinicians with a good anatomical relationship between the abdominal aorta,ureter,and surrounding tissues before surgery,clarify whether there is preoperative ureteral stenosis,prevent possible ureteral injury during open surgery,reduce the occurrence of ureteral stenosis,obstruction,and other conditions after EVAR and open surgery,and this examination is important for abdominal aorta The detection rate of adhesion in the ureter and surrounding tissues is relatively reliable.The ureter and abdominal aorta developed simultaneously,and the normal CTA scan performed 4-5 minutes after the first injection of contrast agent had a satisfactory imaging effect.The image reference value was high,and the feasibility of this examination was high,making it easy to promote.