Exploration of Simplified Intraluminal TEVAR Technique for the Treatment of Aortic Arch Disease.

Bailang Chen,Minxin Wei

doi:10.21470/1678-9741-2020-0057

Abstract

Objective:The positional relationship between the three branches of the aortic arch was determined in normal people. This study provides data to support the customization of aortic arch stents and simplifies intraluminal treatment.Methods:From January 2019 to August 2019, 120 patients who met the inclusion criteria were examined by CT angiography. The ratio of the distance from the midpoint of the three-branch opening onto the anterior wall to the cross-sectional diameter of the aortic arch was calculated. The positional relationship among the three-branch openings was obtained and the data were analyzed statistically.Results:The three-branch openings were not in a straight line. The positional relationship among the three-branch openings was divided into four types, which were not statistically different between sex and age (P>0.05).Conclusion:By measuring the opening position of the three aortic branches, the positional relationship among the three branches was defined to provide a theoretical basis for the design of intraluminal stents and simplified intracavity thoracic endovascular aortic repair (TEVAR) technology.

Highlights

The incidence of aortic arch disease has increased annually due to an aging population and the rise of cardiovascular diseases
Exclusion criteria included: 1) patients diagnosed with arterial diseases such as aortic aneurysms, aortic dissection, aortic wall hematomas, or aortic penetrating ulcers affecting the thoracic aorta and/or aortic arch (AA) branches; 2) inadequate CT scan parameters, range, and image quality, including unsuitable window width and position, or intravascular lumen contrast agents that were poorly filled; 3) patients with severe organic lesions in the chest or mediastinum causing changes in aortic morphology; 4) patients diagnosed with connective tissue diseases, e.g. Marfan syndrome; 5) patients with aortic diseases after surgery; 6) the presence of variations in the AA branches
The left subclavian artery (LSA) was closer to the anterior wall of the aortic arch, the left common carotid artery (LCCA) was closer to the anterior wall, and the brachiocephalic trunk (BCT) was closer to the posterior wall

Summary

Introduction

The incidence of aortic arch disease has increased annually due to an aging population and the rise of cardiovascular diseases. Dissecting aortic aneurysms are characterized by acute onset and severe illness. These patients frequently manifest several symptoms, such as sudden severe pain, shock, and organ ischemia that decrease health status and quality of life of patients[1]. Less invasive thoracic endovascular aortic repair (TEVAR) approaches have been designed to partially substitute traditional thoracotomy for the treatment of most conditions of the thoracoabdominal aorta. Due to the unique anatomical structure of the aortic arch (AA), the use of endovascular approaches to repair the aortic arch has been limited by the tortuosity of the aorta and hemodynamic forces, as well as the need to maintain the perfusion of the vital arch vessels[4,5]

Methods

Results

Discussion

Conclusion