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采用CT血管造影诊断孤立性主动脉弓中断:1例病例报告及文献复习

Isolated interrupted of aortic arch diagnosed using CT angiography: A case report and literature review.

作者信息

Chen Guang-Wen, Li Hang, Pu Hong

机构信息

Department of Radiology, Sichuan Provincial People's Hospital, 32# second section of first ring road, Chengdu, Sichuan, China.

出版信息

Medicine (Baltimore). 2018 May;97(21):e10569. doi: 10.1097/MD.0000000000010569.

Abstract

RATIONALE

Interrupted aortic arch (IAA) is defined as a complete luminal and anatomical interruption between the ascending and descending aortas. The majority of patients with IAA rarely reach adulthood. In most cases, IAA is associated with an intracardiac malformation, such as ventricular septal defect, bicuspidaortic valve, and patent ductus arteriosus. We reported a 70-year-old man with isolated IAA diagnosed using computed tomography angiography (CTA) without previous intervention.

PATIENT CONCERNS

The patient presented with edema of the lower extremities and productive cough.

DIAGNOSES

CTA displayed an interruption of the aortic arch distal to the left common carotid artery (type B) and extensive collateralization.

INTERVENTIONS

The patient refused surgery and underwent conservative therapy with follow-up examinations because of the extensive collateral vascularization.

OUTCOMES

The patient is still currently undergoing conservative therapy with follow-up examinations.

LESSONS

IAA can present in adulthood with different clinical symptoms. Careful physical examination of the lower and upper peripheral pulses in adults with a chief complaint of hypertension is of outmost importance. CTA is a useful noninvasive imaging modality for the morphologic evaluation of aortic interruption and collateral circulation.

摘要

原理

主动脉弓中断(IAA)被定义为升主动脉和降主动脉之间完全的管腔和解剖学中断。大多数IAA患者很少能活到成年。在大多数情况下,IAA与心脏内畸形相关,如室间隔缺损、二叶主动脉瓣和动脉导管未闭。我们报告了一名70岁男性,经计算机断层血管造影(CTA)诊断为孤立性IAA,此前未接受过干预。

患者情况

患者出现下肢水肿和咳痰。

诊断

CTA显示左颈总动脉远端的主动脉弓中断(B型)和广泛的侧支循环。

干预措施

由于广泛的侧支血管形成,患者拒绝手术,接受了保守治疗并进行随访检查。

结果

患者目前仍在接受保守治疗并进行随访检查。

经验教训

IAA可在成年期出现,伴有不同的临床症状。对于以高血压为主诉的成年人,仔细检查上下肢外周脉搏至关重要。CTA是一种用于评估主动脉中断和侧支循环形态的有用的非侵入性成像方式。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/42b0/6392803/8f4c7e50c11c/medi-97-e10569-g001.jpg

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