Clinical Study Of Aortic Arch And Its Branches DSA

Object: To analyze retrospectively 727 patients` digital subtraction angiography (DSA) images of the aortic arch (AA). To analyze the variant types and incidence of the AA and its branched of Henan Province patients, to statistic the incidence of three AA types and the interrelationship of the AA types, gender, age groups and high-risk factors. To establish a Neuro-intervention therapy database.Materials and Methods: To design a database by the free database software Epidata 3.1 Chinese version of Danish, and every case medical information had been inputed.The study analyzed retrospectively 727 patients, who had data integrity of AA DSA images and the medical records, male 466 cases (64.1%), female 261 cases (35.9%), age ranging from 14 to 85 years, median age 57 years, mean age 55.28±13.9 years. The AA branches variation types based on McDonald and Anson, DeGaris`s classification types. The aortic arch can be classified into three types based on the distance of the origin of the innominate artery from the top of the arch. The widest diameter of the left CCA is used as a reference unit. In a type I arch, the innominate artery originates within one diameter length from the top of the arch. In a type II arch, the innominate artery originates within two diameter lengths from the top of the arch. In a type III arch, the innominate artery originates more than two diameter lengths from the top of the arch. The information was analyzed by the cross-table Chi-square (χ2) test, then, the Logistc inspection was used for statistical significant datas, P <0.05 as statistically significant.Results: A single center neuro-intervention database was established.The normal type what usually described three branches arising at arch of aorta were observed in 609 specimens (83.8%). The variation at the major branches of aortic arch were observed in 118 case (16.2%), twenty-five variation types of the AA and its` branches were found. There were six common variation types: (1) common origin of BCT and LCCA, LSCA 65 cases; (2) BCT, LCCA, LVA, LSCA 22 cases; (3) LCCA originated from BCT, LSCA 4 cases; (4) LCCA and RCCA common trunk and RSCA originated from BCT, LSCA 3 cases; (5) no BCT, RCCA, LCCA, LSCA, aberrant RSCA originated from AA 3 cases; (6) common origin of BCT and LCCA, LVA, LSCA 2 cases. The other 19 variation types were 1 case, respectively. The variation type compared difference with gender had no statistically significant (P﹥0.05).In 727 cases, typeⅠarch 325 cases (44.7%), typeⅡarch 228 cases (31.4%), typeⅢarch 174 cases (23.9%).In young group (≤44 years) 162 cases(22.3%), typeⅠ～Ⅲarch 115(15.8%), 36(5.0%), 11(1.5%). In middle-aged group(45～59 years)256 cases(35.2%), typeⅠ～Ⅲarch 131(18.0%), 80(11.0%), 45(6.2%). In the elderly group(60～79 years)298 cases(41.0%), typeⅠ～Ⅲarch 79(10.9%), 108(14.9%), 111(15.3%). advanced age group (≥80 years)11 cases (1.5%), typeⅠ～Ⅲarch 0 (0%), 4(0.6%), 7(1.0%). Three kinds of AA types various age groups, the high-risk factors, hypertension, the history of coronary heart disease, the history of cerebrovascular disease and HDL the comparison difference had the obvious statistics significance (P<0.05). The AA type compared difference with gender, smoking history, history of high blood lipids, history of diabetes, family history of cardio-cerebrovascular disease, fasting blood glucose, CH, TG, LDL and the type of disease had no statistically significant (P﹥0.05). The items used Logistic analysis what comparison difference had statistics significance (P<0.05). The result showed: age groups had statistically significant, the high-risk factor, hypertension, the history of coronary heart disease, the history of cerebrovascular disease and HDL had no statistically significant.Conclusion: Epidata 3.1 Chinese version: free, easy and enough to use. The first large-scale neuro-intervention database in Henan Province was established. It is advantageous to management and following up of the patients. It was helpful to series of retrospective study for Neuro-intervention therapy and providing reference for the design of the prospective research. But the database is still relatively rough, text data and image materials not-in-one, also required further improvement.Twenty-five AA and its` branches variation types were the maximum in the domestic and foreign single central reports which had been reported. Understanding the great vessels of the AA and their variations is important for both the endovascular interventionist, the diagnostic radiologist and surgery doctors. This has become more important in the era of carotid artery stents, vertebral artery stents, and new therapeutic options for intercranial interventions.Eldely, hypertension, the history of coronary heart disease, the history of cerebrovascular disease and HDL unusual were significance for the AA type of technical difficulty during neurointervention therapy. The study first reported the AA type of DSA, the interrelationship of the AA type and each high-risk factor in our country.