Sakamoto I, Hayashi K, Matsunaga N, Matsuoka Y, Uetani M, Fukuda T, Fujisawa H
Department of Radiology, Nagasaki University School of Medicine, Japan.
Radiology. 1994 May;191(2):467-71. doi: 10.1148/radiology.191.2.8153323.
To describe findings in, and the clinical course and outcome of, aortic dissection (dissecting aneurysm) caused by angiographic procedures.
The records of approximately 15,500 angiographic procedures performed between 1985 and 1991 were reviewed. In the six cases of iatrogenic aortic dissection identified, computed tomography (CT) was performed for diagnosis, follow-up, or both.
The type of aortic dissection was Stanford type A in three patients and Stanford type B in three patients. The sites of injury were the abdominal aorta (n = 2), right brachiocephalic artery (n = 2), middle of the thoracic aorta (n = 1), and right common iliac artery (n = 1). One patient had anterograde dissection from the site of injury; two patients, retrograde dissection; and three patients, extensive dissection that extended in both anterograde and retrograde directions. Retrograde dissections decreased in size or disappeared in 1-3 months due to the absence of reentry, whereas anterograde dissections persisted during follow-up (15-27 months). All patient were treated without surgery.
Angiographers should be aware of this potentially serious complication. The extent and type of the aortic dissection can be determined with CT.
描述血管造影术所致主动脉夹层（夹层动脉瘤）的影像学表现、临床病程及转归。
回顾1985年至1991年间约15500例血管造影术的记录。在确诊的6例医源性主动脉夹层病例中，采用计算机断层扫描（CT）进行诊断、随访或两者兼用。
3例患者为斯坦福A型主动脉夹层，3例为斯坦福B型。损伤部位为腹主动脉（2例）、右头臂动脉（2例）、胸主动脉中部（1例）和右髂总动脉（1例）。1例患者从损伤部位顺行剥离；2例患者逆行剥离；3例患者广泛剥离，顺行和逆行方向均有扩展。由于无再入口，逆行剥离在1 - 3个月内缩小或消失，而顺行剥离在随访期间（15 - 27个月）持续存在。所有患者均未接受手术治疗。
血管造影医师应意识到这种潜在的严重并发症。主动脉夹层的范围和类型可通过CT确定。
