Research Of Thoracic Aortic Endovascular Treatment Relevant Aortic Arch Morphology

Research purposesTo investigate the anatomical morphological characteristics of the normal aortic archand then guide the development of artificial blood vessel and new aortic endovasculartreatment equipment. The author quantitatively measured the anatomical characteristicsof the normal type of the three branches of the aortic arch blood vessels located in theaortic arch, i.e., the innominate artery, the left common carotid artery and the leftsubclavian artery branch, by multislice CT angiography in the human body. Then theauthor analyzed the data and established reference ranges of these characteristics.Contents and results, The multislice CT angiography Figures of231patients scannedfrom January2009to October2012which were in accordance with the inclusioncriteria were collected. Three dimentional images of the aortic arch were reformattedand investigated using several image processing techniques. Within the231cases,217cases were of normal aortic arch. The author quantitatively measured of the branchlocation of the innominate artery, the left common carotid artery and the left subclavianarter in the aortic arch, as well as the distance between the branch vessels and thediameter of the branch vessels, and the angle between the sagittal plane of the aorticarch and the connection line of the nnominate artery and the left subclavian artery in thecross section of the aortic arch.The measurement of normal aortic arch and the branches on it.1, measure the the distance between the branches of aortic arch (the innominate artery-the left common carotid artery, the left common carotid artery-the left subclavianartery), 2, measure the diameter of the opening of the three branches on the aortic arch,3, measure the diameter of the thoracic aortic at2cm above the opening of the coronaryartery level,4, statistically analyze the data stratified according to the gender and age,Resultsl, the distance between the branches: innominate artery-the left common carotid arterywas4.39±2.49mm, the left common carotid artery-the left subclavian artery was6.43±3.98mm.2, diameter of the opening of the branch arteries: innominate artery was12.50±1.95mm, the left common carotid artery was8.28±1.51mm, the left subclavian artery was10.41±2.20mm.3. The diameter of aortic was34.56±4.72mm.Analysis1, There was no statistically significant difference (P>0.05) in the distance between theinnominate artery-the left common carotid artery and the left common carotid artery-the left subclavian artery between different gender and ages2, There was statistically significant difference (P <0.05) between different ages but nostatistically significant difference (P>0.05) between different gender in the diameter ofthe opening of the innominate artery,There was no statistically significant difference (P>0.05) in the diameter of theopeningof the left common carotid artery between different ages and gender.There was statistically significant difference (P <0.05) in the diameter of the opening ofthe left subclavian artery between different genders, the diameter was larger in the mailthan in the females; There was no statistically significant difference (P>0.05) in thediameter of the opening of the left subclavian artery between different ages.3, There was statistically significant difference (P <0.05) in the diameter of the aorticbetween different ages. The diameter of the aortic was significantly large in cases that more than61years old than that in cases of18-40years old as well as of41-60yearsold. There was no statistically significant difference (P>0.05) in the diameter of theaortic between18-40years old group and41-60years old group. and aortic diameter in18-40years and41no statistically significant difference between the-60age group.There was no statistically significant difference (P>0.05) in the diameter of the aorticbetween male and female.The measurement and analysis of the angle of the normal aortic arch1, measure the angle between the sagiittal plane and the connection line of of theinnominate artery and the left subclavian artery in the cross section of the aortic.2, analyze the data stratified according to gender and age.The average angle was50.30±13.79°and there was no significant difference in thisangle between different genders and ages (P>0.05).The author gained the data of the diameter of the thoracic aorta and the diameter of theopening of the branch vessels on the aortic arch and the distance between them bymeasuring the morphology of the thoracic aorta in231normal cases. These data wereneeded as a reference in several endovascular methods which could treat the aortic archlesions, including debranching technology with standard stent, in situ fenestration in thestandard stent and the use of individualized stent or Window branch stent supplies, etc.,these methods have been applied more and more commonly nowadays. Meanwhile,these data could be used as a guide to development of the ideal normalized(off-the-shelf) window or branch stent. The tendency of increased aortic diameter inmore than61years old people should be fully considered when choosing the stentduring aortic endovascular repair. The distance between the vast majority of the leftcommon carotid artery and left subclavian artery is less than15mm, while20mm isconsidered to be the minimum value to ensure non-occurrence of endoleaks in proximal landing zone, so it could be concluded that it is impossible to successfully treat most ofthe aortic lesions simply by expanding the stent in the thoracic aortic when the leftsubclavian artery is involved. The distortion of the aortic arch morphology could bedescribed in the different way through the the angle between the sagiittal plane and theconnection line of of the innominate artery and the left subclavian artery in the crosssection of the aortic.