文章摘要

腔内介入治疗自发性孤立性肠系膜上动脉夹层的短中期疗效

作者: 1罗晓苗, 1张希全, 1钟山, 1葛世堂
1 中国人民解放军第一四八医院 全军腔内介入诊疗中心,山东 淄博255300
通讯: 张希全 Email: zyfbb19901024@sina.com
DOI: 10.3978/.10.3978/j.issn.1005-6947.2016.12.006
基金: 军队科研计划重点基金资助项目, CJN14J010

摘要

目的:探讨腔内介入治疗自发性孤立性肠系膜上动脉夹层(SISMAD)的短中期临床效果。方法:回顾性分析2009年3月—2016年8月收治的16例SISMAD患者资料,根据Sakamoto分型,其中I型3例(18.75%),II型3例(18.75%),III型10例(62.5%)。结果:1例I型患者经保守治疗效果满意,2例I型患者、3例II型患者、5例III型患者行单支架植入术,5例III型患者行双支架植入术(其中1例III型患者真腔狭窄约95%,行球囊扩张后植入2枚支架)。所用支架均为自膨式裸支架。随访1~34个月,中位时间16个月,均未再发相关性腹痛等症状,腹部CTA显示夹层假腔不显影,支架无移位、变形,支架腔内无狭窄、闭塞。结论:腔内介入治疗SISMAD的短中期效果好,但其长期效果需进一步观察。
关键词: 动脉瘤,夹层 肠系膜上动脉 血管内操作

Short- to mid-term efficacy of endovascular intervention for spontaneous isolated superior mesenteric artery dissection

Authors: 1LUO Xiaomiao, 1ZHANG Xiquan, 1ZHONG Shan, 1GE Shitang
1 Endovascular Interventional Diagnosis and Treatment Center, the 148th Hospital of Chinese People’s Liberation Army, Zibo, Shandong 255300, China

CorrespondingAuthor:ZHANG Xiquan Email: zyfbb19901024@sina.com

Abstract

Objective: To investigate the short- to mid-term clinical efficacy of endovascular intervention for spontaneous isolated superior mesenteric artery dissection (SISMAD). Methods: The clinical data of 16 patients with SISMAD treated from March 2009 to August 2016 were retrospectively analyzed. Of the patients, the dissection was classified as type I in 3 cases (18.75%), type II in 3 cases (18.75%) and type III in 10 cases (62.5%) according to Sakamoto’s classification. Results: One type I patient underwent conservative treatment with satisfactory results, 2 type I patients, 3 type II patients and 5 type III patients underwent single-stent implantation, and 5 type III patients underwent double-stent implantation (one type III case with nearly 95% stenosis in the true lumen had balloon dilation before placement of two stents). All the stents used were self-expanding type. Follow-up was conducted for 1 month to 34 months with a median follow-up time of 16 months, no disease-associated abdominal pain was noted, and CTA showed no flow of contrast in the false lumen and no stent migration or deformation and intra-stent stenosis or occlusion occurred. Conclusion: Endovascular intervention offers favorable short- to mid-term results in treatment SISMAD and however, its long-term outcomes should be further determined.
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