2021 Volume 6 Issue 3 Pages 119-126
Objective: The aim of this study was to evaluate the relationships between approach time and anatomical factors of the aortic arch in endovascular therapy. Whether 2D images of plain computed tomography (2DCT) could provide imaging information about the aortic arch equivalent to those of contrast-enhanced three-dimensional computed tomography angiography (3DCTA) was also investigated.
Methods: A retrospective review of our institutional database was performed to identify 65 patients who underwent endovascular treatment via the femoral artery and 3DCTA between January 2017 and June 2019. The anatomical factors of the aortic arch were evaluated, including the angle between the target vessel and the aortic arch (apex, inferior margin) and the distance from the apex of the aortic arch to the target vessel on 2DCT and 3DCT. The relationships between patients' characteristics and the procedure were investigated. The approach time was defined as the time from puncture to target angiography after guiding catheter placement.
Results: The average approach time was 24.4 minutes. On 2DCT and 3DCTA measurements, the correlation coefficients with the distance from the apex of the aortic arch to the target vessel (r=0.858) and with the angle between the target vessel and the inferior margin of the aortic arch (r=0.721) were strong. The approach time was linearly correlated with the distance from the apex of the aortic arch to the target vessel (r=0.478). In addition, the approach time was negatively correlated with the angle between the aortic arch and the target vessel (r=−0.197), and a stronger correlation was observed for the angle between the target vessel and the inferior margin of the aortic arch (r=−0.298).
Conclusion: The 2D images of plain CT can provide imaging information about the aortic arch equivalent to those of 3DCTA. The approach time becomes longer when the distance from the apex of the aortic arch to the target vessel is long or when the angle between the inferior margin of the aortic arch and the target vessel is acute.
