Clinical Study Of 2D-DSA And 3D-DSA In The Diagnosis And Treatment Of Carotid Artery Stenosis

Objective To explore the application value of 3D digital subtraction angiography(3d-dsa)and 2D digital subtraction angiography(2D-DSA)in the diagnosis and treatment of carotid artery stenosis.Materials and methods Using retrospective analysis,from September 2014 to August 2017,61 hospitalized patients in general surgery,which diagnosed carotid stenosis by color ultrasound or CTA.Altogether 122 arteries,72 of them are narrow carotid arteries,remove 50 arteries with no apparent stenosis.To discuss the distribution characteristics of different risk factors(such as patient's gender,past asymptomatic,combined diseases,etc.),2D-DSA and 3D-DSA were performed after their admission,and compare the differences in the degree of stenosis,the detection of ulcer plaque,the radiation dose,the dosage of angiography,and the evaluation of surgical indications between two methods.The carotid artery was evaluated comprehensively by 3D-DSA examination and formulate a specific surgical plan.Results In this study,a total of 61 hospitalized patients,aged from 53 to 89,with an average age of 70.2 years.Among them,32 patients had one or more risk factors,32patients with Hypertension,25 patients with smoking,34 patients with diabetes,and 29 people with hyperlipidemia.According to the previous six months if there is a relevant clinical symptoms of cerebral ischemia all patients are divided into:Asymptomatic carotid artery stenosis group 15 cases,symptomatic carotid stenosis group 21 cases.The diagnostic value of 2D-DSA and 3D-DSA in the grading of carotid artery stenosis was comparable,and have a good consistency(Kappa=0.697);But the mean value of 2D-DSA was lower than 3D-DSA(P=0.000<0.05),it indicates that there are differences in stenosis value between the two methods.There are significant differences between the two methods(P=0.017<0.05)in detecting ulcer plaque;The dosage of contrast agent(P=0.000<0.05)and the radiation dose(P=0.000<0.05)were statistically significant;The differences between 2D-DSA and 3D-DSA in the indications of carotid stenosis were statistically significant(P= 0.01),and the difference between the symptom group(P= 0.031)and the asymptomatic group(P=0.035)was statistically significant.Conclusion? In the judgment of the degree of carotid artery stenosis,3D-DSA has a good agreement with 2D-DSA,but 2D-DSA stenosis is lower than 3D-DSA,3D-DSA is more specific and sensitive;?3D-DSA is significantly better than 2D-DSA for detection of ulcer plaque;? 3D-DSA is less than 2D-DSA in the use of contrast agent and radiation dose in patients;?3D-DSA is more valuable in assessing treatment options.