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The Clinical Application of C-arm Computed Tomography(Dyna CT) in Carotid Arterial Dissection Aneurysm

Author: LiuChangJiang
Tutor: LiuXiaoDong
School: Jilin University
Course: Public Health
Keywords: C-armCT (Dyna CT) Endovascular treatment Carotid arterydissection Stent
CLC: R739.91
Type: Master's thesis
Year: 2013
Downloads: 18
Quote: 0
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Abstract


Objective: To differentiate and compare the specificity and sensitivity indiagnosing the location, structure, length of the carotid artery dissection lesion byusing Dyna CT or2D and3D DSA, and to choose the best interventional treatmentplan, improve the surgical success in clinical application.Methods:1.Source of case and grouping:112patients diagnosed with carotidartery dissection in Changhai Hospital, Second Military Medical University from Apr2011to May2013, were selected and randomly divided into two groups.55cases in Igroup underwent interventional treatment in Simens double flat detector angiographyoperating room with Dyna CT,57cases in group II underwent interventionaltreatment in Simens double flat detector angiography operating room without DynaCT.2.Following indicators were used to compare the treatment in two groups: a)diagnosing the location of rupture through the size of the intimal flap. b) identifyingthe sensitivity of lesion length of dissection and comparing to the normal carotid. c)calculating a ratio (stent length: lesion length) in order to accurately cover thedissecting lesion.d) cure rate and recurrence rate during follow up in6months and ayear duration through DSA examination.e)The radiation dose of DynaCT examinationsecurity.3.Data processing and analysis using SPSS17statistical software, methods oftest for chi square test, t test, P <0.05difference has statistics significance.Results:In Group I the dissection lesion in33cases were identified accuratelywhile the rest22cases were not clearly identified. In Group II the dissection lesion in17cases were identified accurately while the rest40cases were not clearly identified.The differences between two groups were significant (p <0.05). Statistical value onratio of stent length and dissection lesion, group I ratio was less than group II (p<0.05). Intraoperative and postoperative complication rate in both the groups wasnot statistically significant (p>0.05). Rate of complete occlusion on immediatepostoperative follow up was significantly higher in group I patients (p<0.05). Byreducing the operation of operation time and filmed number can be offset by increasedradiation dose DynaCT examination.Conclusion:By comparing use of intraoperative Dyna CT with2D and3D DSAin patients with carotid artery dissection, the site of dissection, rupture, structure anddissection length can be determined more accurately. Moreover, the appropriate lengthof the stent can be chosen reducing the chance of over coverage of normal bloodvessel,It can improve the rate of complete embolism operation initial treatment,reduce recurrence rate after operation providing more surgical safety and highertreatment success rate. At the same time, the application of Dyna CT did not increasethe intraoperative radiation dose to the patient and surgeon to cause additionaldamage.

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