Abstract

BACKGROUND: This study aimed to investigate the role of dual-source computed tomography angiography (DSCTA) to evaluate the anatomy of the aortic arch vessels in patients with acute Type A aortic dissection (AD).

MATERIAL AND METHODS: A retrospective clinical study included 42 patients with acute Type A AD who underwent DSCTA and were treated in our hospital between January 2018 and December 2018. The findings were compared with a control group of 45 healthy individuals with hypertension and without aortic arch lesions.

RESULTS: The diagnostic accuracy of DSCTA in patients with acute Type A AD was almost 100%. The innominate artery was most frequently affected. The mean DSCTA imaging measurements for the root of the innominate artery, the left common carotid artery, and the left subclavian artery, in the coronal plane of the aortic arch, were 17.7±3.7 mm, 17.7±3.7 mm, and 12.9±3.1 mm, respectively. The angles formed by the origin of the three aortic arch branches vessels and the aortic arch were 70.5±10.2°, 58.5±15.5°, and 90.2±22.7°, respectively. In the transverse plane of the aortic arch, the mean angles were 110.5±22.3°, 100.3±15.2°, and 95.4±10.6°, respectively. These DSCTA imaging findings were significantly different in the patient group compared with the control group.

CONCLUSIONS: DCTA demonstrated that patients with Type A AD showed anatomic differences in the aortic arch vessels. These findings may help surgeons to develop treatment strategies and select the most appropriate vascular grafts and stents.

Keywords: Aorta, Thoracic, Dissection, multidetector computed tomography, Aneurysm, Dissecting, Angiography, Aortic Aneurysm, Thoracic, Blood Vessel Prosthesis, Blood Vessel Prosthesis Implantation, computed tomography angiography, endovascular procedures, Middle Aged, Retrospective Studies, Stents, Tomography, X-Ray Computed, Treatment Outcome