The aortic remodeling comparative study of contrast enhanced ultrasound and CT angiography in DeBakey type III aortic dissection after thoracic endovascular aortic repair

Abstract

Objective To compare the different features of contrast enhanced ultrasound(CEUS) and CT angiography (CTA) in abdominal aortic remodeling after thoracic endovascular aortic repair (TEVAR) of DeBakey type Ⅲ aortic dissection(AD), and to investigate the application value of CEUS in the follow-up of DeBakey type Ⅲ AD after TEVAR. Methods CEUS was performed in 28 patients with DeBakey type Ⅲ AD after TEVAR, in which 8 cases type Ⅲa (simple type) were not involved of abdominal aorta, 20 cases Ⅲb(complex type) were involved in the abdominal aorta, all patients were performed CTA examination of aorta. The functional and morphological changes of abdominal aortic remodeling were observed by two methods in DeBakey type Ⅲ AD after TEVAR. Results There was no new rupture of the abdominal aorta in 8 cases type Ⅲa AD, but 20 cases of type Ⅲb AD showed the situation of ruptures, thrombosis, trues and falses lumen after 3 months of follow-up. CEUS was less than CTA in detecting the number of ruptures (P 0.05), but CEUS clearly showed the hemodynamic characteristics of abdominal aortic intimal tear, the size and position of rupture, moving blood flow of rupture, and true or false lumen, which provided more accurate data for the long term abdominal aortic remodeling of DeBakey type Ⅲ AD after TEVAR. Conclusions CEUS and aortic CTA can play a complementary role in DeBakey type Ⅲ AD after TEVAR of long-term follow-up, it is worth promoting. Key words: Contrast-enhanced ultrasound; Aortic dissection; Thoracic endovascular aortic repair; Aortic remodeling