专题研究(Monographic Study)

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

Published at: 2016年第25卷第12期

罗晓苗 1 , 张希全 1 , 钟山 1 , 葛世堂 1
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
通讯作者 希全 张 Email: zyfbb19901024@sina.com
DOI: 10.3978/j.issn.1005-6947.10.3978/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。


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

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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引用

引用本文: 晓苗 罗, 希全 张, 山 钟, 世堂 葛. 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[J]. 中国普通外科杂志, 2016, 25(12): 1701-1706.
Cite this article as: LUO Xiaomiao, ZHANG Xiquan, ZHONG Shan, GE Shitang . Short- to mid-term efficacy of endovascular intervention for spontaneous isolated superior mesenteric artery dissection [J]. Chin J Gen Surg, 2016, 25(12): 1701-1706.