Aortic Arch Variants: A Practical Guide to Safe and Timely Catheterization
Aortic Arch Variants: A Practical Guide to Safe and Timely Catheterization
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主动脉弓变异：安全及时插管实用指南
DOI：
10.1159/000491940
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发表时间：
2018
影响因子：
--
通讯作者：
P. Nelson
中科院分区：
文献类型：
--
作者：
M. Shapiro;E. Raz;P. Nelson
背景资料：主动脉弓解剖结构的变化已经从多个角度进行了广泛的描述，包括大体解剖学、胚胎学、相关的心脏和其他异常、早期生命表现和横断面诊断。然而，缺乏强调安全和及时导管插入术的文献，特别是在急诊或其他导管血管造影术期间发现变异时，而没有既往横断面血管成像的益处。本次审查的目的是试图填补这一空白。研究方法：我们回顾了过去1,000例诊断性和治疗性导管插入术，以确定弓形变异，并按我们机构遇到的频率顺序列出。结果如下：这些变体以插图和导管血管造影图像的形式呈现，重点是安全有效的术中诊断和导管插入术。结论：熟悉或多或少常见的主动脉弓变体，沿着猪尾主动脉弓血管造影术的低阈值以及通用和弯曲导管的舒适使用，将确保在绝大多数遇到的变体中取得成功。
Background: Variations in aortic arch anatomy have been extensively described from multiple perspectives including gross anatomy, embryology, associated cardiac and other anomalies, early life presentation, and cross-sectional diagnosis. There is however a paucity of literature with an emphasis on safe and timely catheterization, particularly when the variants are found during emergent or other catheter angiographic procedures without benefit of prior cross-sectional vascular imaging. The purpose of this review is to try to fill this gap. Methods: A review of past 1,000 diagnostic and therapeutic catheterizations was performed to identify arch variants, which are presented in order of frequency encountered at our institutions. Results: The variants are presented as illustrations and catheter angiographic images, with emphasis on safe and efficient intraprocedural diagnosis and catheterization. Conclusion: Familiarity with more and less common arch variants, along with low threshold for performance of pigtail aortic arch angiography and comfort in use of general purpose and recurved catheters, will ensure success in the vast majority of encountered variations.