Seo Jung Min, Park Kwang Bo, Kim Keon Ha, Jeon Pyoung, Shin Sung Wook, Park Hong Suk, Do Young Soo, Kim Dong-Ik, Kim Young-Wook
Department of Radiology, Sungkyunkwan University School of Medicine, Seoul, Korea.
Acta Radiol. 2011 Oct 1;52(8):854-9. doi: 10.1258/ar.2011.110063. Epub 2011 Aug 12.
There are very few reports regarding the use of 3D rotational angiography (3D RA) in embolization of renal artery aneurysms (RAAs). No valuable data have been reported on the follow-up result of coil embolization for RAAs on computed tomography (CT). Purpose To evaluate the clinical and multidetector computed tomography (MDCT) follow-up results of renal artery aneurysms treated by detachable coil embolization using 3D RA.
Six patients diagnosed with RAAs were included. Five patients underwent detachable coil embolization. Five patients underwent 3D RA and the parameters used for planning endovascular treatment obtained by 2D CT, reformatted 3D CT angiography (3D CTA), 2D digital subtraction angiography (2D DSA) and 3D RA were compared. The postembolization MDCT follow-up findings were analyzed retrospectively.
The technical success rate for detachable coil embolization was 40%. The 3D CTA showed the dome-to-neck ratio (DNR) and tangential view of the renal artery aneurysm in five patients (83.3%) and the 2D CT showed it in four (66.7%). An optimal working angle assessment could not be obtained on the 2D CT and 3D CTA. The 3D RA showed the DNR, tangential view, and optimal working angle in all patients. Renal infarction occurred in three patients and postprocedural hypertension developed in two patients during the follow-up period.
The 3D RA was useful in preoperative determination of adequate working angle for detachable coil embolization of RAAs. Late complications of detachable coil embolization for RAAs were renal infarction and hypertension.
关于三维旋转血管造影(3D RA)在肾动脉瘤(RAA)栓塞术中的应用报道极少。关于肾动脉瘤弹簧圈栓塞术后计算机断层扫描(CT)随访结果,尚无有价值的数据报道。目的:评估使用3D RA进行可脱卸弹簧圈栓塞治疗肾动脉瘤的临床及多排螺旋CT(MDCT)随访结果。
纳入6例诊断为肾动脉瘤的患者。5例患者接受了可脱卸弹簧圈栓塞术。5例患者接受了3D RA,并比较了通过二维CT、重组三维CT血管造影(3D CTA)、二维数字减影血管造影(2D DSA)和3D RA获得的用于血管内治疗规划的参数。对栓塞术后MDCT随访结果进行回顾性分析。
可脱卸弹簧圈栓塞术的技术成功率为40%。3D CTA显示了5例患者(83.3%)肾动脉瘤的瘤顶与瘤颈比(DNR)及切线位图像,二维CT显示了4例患者(66.7%)的上述情况。二维CT和3D CTA无法获得最佳工作角度评估。3D RA显示了所有患者的DNR、切线位图像及最佳工作角度。随访期间,3例患者发生肾梗死,2例患者出现术后高血压。
3D RA有助于术前确定肾动脉瘤可脱卸弹簧圈栓塞的合适工作角度。肾动脉瘤可脱卸弹簧圈栓塞的晚期并发症为肾梗死和高血压。