摘要
目的评价血管腔内介入治疗自发性孤立性肠系膜上动脉夹层(spontaneous isolated superior mesenteric artery dissection,SISMAD)的有效性和安全性。方法回顾性分析2009年3月至2016年5月期间笔者所在医院收治的17例SISMAD患者的临床资料。根据Sakamoto血管影像学分型,Ⅰ型3例,Ⅱ型5例,Ⅲ型9例;3例Ⅰ型患者接受内科保守治疗,保守治疗不理想者及其他患者接受介入治疗。结果保守治疗成功1例,共16例接受介入治疗,技术成功率为100%;11例患者置入支架1枚,5例患者置入支架2枚;术中造影检查显示肠系膜上动脉(superior mesenteric artery,SMA)真腔血流通畅,无严重并发症发生。17例患者均获随访,随访时间3~36个月,平均19个月,17例患者均无腹痛症状发生,SMA的CTA检查显示夹层动脉瘤不显影,SMA和支架内血流通畅。结论腔内介入治疗SISMAD是一种微创、安全及有效的方法。
Objective To evaluate the clinical efficacy and safety of endovascular therapy for spontaneous isolated superior mesenteric artery dissection （SISMAD）. Methods The clinical data of 17 patients with SISMAD, who were treated at author＇s hospital during the period from March 2009 to May 2016, were retrospectively analyzed. According to the Sakamoto angiographic classification, patients were divided into type I （n=3）, type II （n=5）, and type III （n=9）. Three patients with type I were treated with conservative treatment first, and then 2 were treated with endovascular therapy as the poor reaction. The other patients were treated with endovascular treatment right a way. Results Conservative treatment was success in 1 case, 16 patients were treated with endovascular treatment, the technical success rate was 100%, one stent was used in 11 patients and two stents were used in 5 patients, and the blood in the true lumen of superior mesenteric artery （SMA） restored, no major complications occurred. Seventeen patients were followed- up for 3-36 months （mean of 19 months） and the followed-up rate was 100%, no abdominal pain occurred in 17 cases, CTA showed that no dissecting aneurysm was observed and the stents were patent of SMA. Conclusion Interventional therapy is a safe and effective method for SISMAD.
出处
《中国普外基础与临床杂志》
CAS
2017年第4期449-452,共4页
Chinese Journal of Bases and Clinics In General Surgery
基金
军队后勤科研计划资助项目(项目编号:CJN14J010)
关键词
肠系膜上动脉
夹层
动脉瘤
支架
superior mesenteric artery
dissection
aneurysm
stent
