Clinical value of ultrasound quantitative analysis of superior mesenteric artery perfusion before and after TEVAR in Stanford type B aortic dissection

LIU Fengju; PU Xin; HUANG Lianjun

Abstract：Objective To assess the clinical value of ultrasound in quantitative analysis of perfusion of superior mesenteric arteries before and after TEVARin Stanford type B aortic.Methods The subjects of this study were 105 patients with superior mesenteric artery involvement in type B aortic dissection treated with TEVAR for the first time at our hospital.Aortic CTA exami-nation was completed 3 days before and 1,3,6 months after TEVAR.Aortic ultrasound was performed before and 24 hours after TEVAR and blood flow parameters of the superior mesenteric artery were recorded.The groups were divided,according to the type of SMA involvement into Dynamic ischemia,and SMA opening in small real-lumen groups.The details in static ischemia were as follows:as for group A,the SMA opened in the false lumen and no re-entry tears were observed at the level of the open-ing;for group B,the SMA opening was in the false lumen and the re-entry tear was visible at the level of the opening;for group C,the SMA opened in the false lumen and ridden across the true and false lumen;for group D,the SMA opening was in the false lumen,the dissection was formed and the blood supply was mainly in the true lumen,and with respect togroup E,the SMA open-ing was in the false lumen,the dissection was formed,and the blood supply was mainly in the false lumen.Pair t-tests were used to compare pre-and post-operative blood flow parameters.Results PSV and VolFlow increased after operation in small true-lumen group and groupD.After TEVAR,MDV decreased and VolFlow increased in Group B,VolFlow decreased in group E.These differences were statistically significant in above comparisons(P<0.05).Conclusion Ultrasound can monitor the hemo-dynamic evolution of mesenteric ischemia due to aortic dissection and provide information for the prevention and treatment of mesentery malperfusion syndrome.