| Objective:Cerebrovascular disease is the most serious reasons of death and disability among urban and rural residents in China.Digital subtraction angiography(DSA)is still the golden standard for the diagnosis of cerebrovascular diseases.DSA is a method of injecting contrast agent into cerebral vessels,taking rapid and continuous films,and obtaining subtracted images after processing by digital computer technology.Aortic arch is the necessary vessel for cerebrovascular intervention,and the classification of aortic arch has a significant impact on cerebrovascular intervention.By studying the influencing factors of aortic arch shape and the influence of aortic shape on DSA,it is of obvious guiding significance to increase the success rate and reduce the operational risk of cerebrovascular intervention.The study of the influence of aortic arch classification on DSA can provide some theoretical support for the design of interventional materials.Materials and Methods: The imaging data and clinical data of 879 patients who underwent DSA in the First Affiliated Hospital of Dalian Medical University from September 2017 to December 2019 were collected.According to Myla classification standard,the aortic arch morphology of patients was divided into three types throgh experienced physician;Collected the general clinical data of patients and the dosage of contrast agent,operation time and whether special contrast catheter was used during DSA;Analyzed the influencing factors of aortic arch morphology and the correlation between aortic classification and DSA.Result:Of the 879 patients,406(46.2%)were type I aortic arch,300(34.1%)were type ? aortic arch,and 173(19.7 %)were type ? aortic arch.There were 207 cases in the young group(?45 years).there were found in 146(70.2%),51(24.6%)and 10(4.8%)cases respectively.Among the 349 patients in the middle age group(46-59 years old),there were 182(52.1%)patients with type I aortic arch,126(36.1%)patients with type ? aortic arch,and 41(11.7%)patients with type ? aortic arch.In the elderly group(?60 years old),there were 323 cases of type I aortic arch(78 cases)(24.1%),type ? aortic arch(123 cases)(38.1%),and type ? arch(122 cases)(37.8%).Gender:194 males and 212 females with type I aortic arch;There were 156 males and 144 females with type ? aortic arch.Type ? aortic arch was found in 91 males and 82 females.History of hypertension: 207 cases with type I aortic arch,257 cases with type ? aortic arch,and 148 cases with type ? aortic arch.Diabetes history: 200 cases with type I aortic arch,154 cases with type ? aortic arch,and 80 cases with type ? aortic arch.History of smoking: 160 cases with type I aortic arch,118 cases with type ? aortic arch,and 68 cases with type ? aortic arch.History of coronary heart disease: 233 cases with type I aortic arch,173 cases with type ? aortic arch,and 100 cases with type ? aortic arch. The X ray exposure time during DSA was 11.2±2.1min,12.4±3.1min and 20.5±7.4min respectively.The contrast doses were 20±7ml,24±11ml and 40±17ml respectively.Simmons catheter was used in 0 cases of type I arch and 4 cases of type ? arch(1.3%),significantly higher than 12 cases of type ? arch(6.9%).Conclusion:1.With the increase of age,type ? and type ? aortic arch have a gradual increase trend.2.The blood pressure of patients has obvious influence on the shape of aortic arch.3.The shape of aortic arch has obvious influence on DSA.Compared with type I and type ?,the operation time,contrast agent dosage and Siomons catheter usage of type ? aortic arch were increased. |
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