Iezzi Roberto, Cotroneo Antonio Raffaele, Marano Riccardo, Filippone Antonella, Storto Maria Luigia
Department of Radiology, University G. D'Annunzio, Chieti, Italy.
Eur J Radiol. 2008 Mar;65(3):365-76. doi: 10.1016/j.ejrad.2007.09.022. Epub 2007 Oct 22.
Endovascular procedures with placement of stent-graft has become an accepted alternative to traditional open surgery for treatment of descending thoracic aortic aneurysms, ulcers, post-traumatic rupture, or complications of type-B dissection, due to significant reduction in perioperative mortality, rate of complications and length of hospitalization. Moreover, increasing operator experience and continuous advances in stent-graft technology are making treatment of a wider range of cases possible with redefinition of guidelines for endovascular stent-graft. The feasibility of endovascular stent-graft is mainly dependent on anatomic factors which represent the important predictors of the success of this procedure as well as on strictly follow-up in order to obtain early detection and treatment of eventual complications. Multi-detector CT-angiography is a fast, safe, and minimally invasive imaging technique that represents the standard of reference in the follow-up of patients who have undergone endovascular stent-graft, as it is effective and specific in the detection of procedure-correlated complications. The purpose of this article is to give a brief review of those techniques most commonly used for endovascular treatment of thoracic aortic diseases together with a more detailed description of post-procedural complications and their appearance on multi-detector CT-angiography.
由于围手术期死亡率、并发症发生率和住院时间显著降低,置入覆膜支架的血管内手术已成为治疗降主动脉瘤、溃疡、创伤后破裂或B型夹层并发症的传统开放手术的一种可接受的替代方法。此外,随着术者经验的增加以及覆膜支架技术的不断进步,血管内支架植入指南的重新定义使得治疗更广泛的病例成为可能。血管内覆膜支架的可行性主要取决于解剖因素,解剖因素是该手术成功的重要预测指标,同时也取决于严格的随访,以便早期发现并治疗可能出现的并发症。多排螺旋CT血管造影是一种快速、安全且微创的成像技术,是接受血管内覆膜支架植入术患者随访的参考标准,因为它在检测与手术相关的并发症方面有效且具有特异性。本文旨在简要回顾最常用于胸主动脉疾病血管内治疗的技术,并更详细地描述术后并发症及其在多排螺旋CT血管造影上的表现。