Kitada Yuichiro, Okamura Homare, Teshima Kengo, Akiyoshi Kei, Nomura Yohei, Mieno Makiko, Adachi Hideo
Department of Cardiovascular Surgery, Nerima Hikarigaoka Hospital, 1-5-2, Hikarigaoka, Nerima-ku, Tokyo, Japan.
Department of Medical Informatics, Center for Information, Jichi Medical University, 3311-1, Yakushiji, Shimotsuke, Tochigi, Japan.
Gen Thorac Cardiovasc Surg. 2025 Jan 25. doi: 10.1007/s11748-025-02121-6.
Branched prostheses are used to treat aortic arch with dissection. However, changes in the neck vessel geometry and diameter after dissection are not well known. We aimed to evaluate neck vessels geometry and changes in diameter with dissection.
A total of 209 patients admitted to our hospital for acute type A aortic dissection, and we excluded patients with insufficient computed tomography image to evaluate neck vessels; as such 201 patients were included. We measured the neck vessels geometry with or without dissection, and additionally evaluated the pre- and postdissection neck vessel diameters in 16 patients for whom predissection computed tomography were available.
The average differences between the non-dissected and dissected vessels were 3.0 mm in proximal innominate artery (IA), 2.8 mm in distal IA, 2.5 mm in proximal left carotid artery (LCCA), 3.1 mm in distal LCCA, 2.7 mm in proximal left subclavian artery (LSA), and 1.9 mm in distal LSA. The average pre- and postdissection diameters of the neck vessels were as follows: IA: 15.1 ± 2.6 and 16.7 ± 3.2 mm (P = 0.002); LCCA: 10.7 ± 0.9 and 12.3 ± 1.2 mm (P = 0.054); and LSA: 12.4 ± 2.5 and 12.8 ± 2.1 mm (P = 0.32).
In patients with acute type A aortic dissection, dissected neck vessels diameter is significantly larger than that of the non-dissected neck vessels diameter. However, the postdissection diameter changes in the neck vessels were mostly <2 mm.
分支型人工血管用于治疗主动脉弓夹层。然而，夹层后颈部血管的几何形态和直径变化尚不清楚。我们旨在评估夹层时颈部血管的几何形态和直径变化。
共有209例因急性A型主动脉夹层入住我院的患者，我们排除了计算机断层扫描图像不足以评估颈部血管的患者；最终纳入201例患者。我们测量了有或无夹层时的颈部血管几何形态，并额外评估了16例有夹层前计算机断层扫描图像的患者夹层前后的颈部血管直径。
未夹层和夹层血管之间的平均差异为：无名动脉（IA）近端3.0mm，IA远端2.8mm，左颈总动脉（LCCA）近端2.5mm，LCCA远端3.1mm，左锁骨下动脉（LSA）近端2.7mm，LSA远端1.9mm。颈部血管夹层前后的平均直径如下：IA：15.1±2.6和16.7±3.2mm（P = 0.002）；LCCA：10.7±0.9和12.3±1.2mm（P = 0.054）；LSA：12.4±2.5和12.8±2.1mm（P = 0.32）。
在急性A型主动脉夹层患者中，夹层的颈部血管直径明显大于未夹层的颈部血管直径。然而，夹层后颈部血管直径变化大多<2mm。
