[1]刘大伟,张曦彤,韩向军,等.症状性内脏动脉夹层影像学诊断和介入治疗[J].介入放射学杂志,2015,(07):582-587.
 LIU Da-wei,ZHANG Xi-tong,HAN Xiang-jun,et al.Symptomatic splanchnic artery dissection: imaging diagnosis and interventional treatment[J].journal interventional radiology,2015,(07):582-587.
点击复制

症状性内脏动脉夹层影像学诊断和介入治疗 ()

PDF下载中关闭

分享到:

《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
期数:
2015年07期
页码:
582-587
栏目:
血管介入
出版日期:
2015-07-25

文章信息/Info

Title:
Symptomatic splanchnic artery dissection: imaging diagnosis and interventional treatment
作者:
刘大伟 张曦彤 韩向军 梁松年
Author(s):
LIU Da-wei ZHANG Xi-tong HAN Xiang-jun LIANG Song-nian
Department of Interventional Vascular Surgery, Chengde Municipal Central Hospital, Chengde, Hebei Province 067000, China
关键词:
【关键词】 内脏动脉夹层 影像学特征 血管腔内支架植入
文献标志码:
A
摘要:
【摘要】 目的 总结症状性内脏动脉夹层(SAD)影像学诊断和介入治疗经验。方法 回顾中国医科大学附属第一医院20066月至20143月收治的21例症状性SAD患者的诊断和治疗方法,并结合相关文献进行分析。结果 腹部增强CTCTA检查显示15例为肠系膜上动脉夹层,5例腹腔干动脉夹层,1例脾动脉夹层。5例保守治疗患者中1例并发肝动脉血栓形成。16例血管腔内支架植入术(ESP)治疗患者中2例行ESP联合肠切除术,2例行置管溶栓联合ESP治疗;围手术期均未发生严重并发症。全部患者随访274个月,平均19.1个月。ESP治疗患者腹部疼痛及血便症状明显缓解或消失,无腹痛复发;CTA显示支架内血流通畅,位置良好,无管腔狭窄及血栓形成。1例肠系膜上动脉夹层患者术后3个月因脑卒中死亡。结论 症状性SAD应早期诊断、早期治疗。CTA检查能确诊大多数病变,但要注意不典型表现;ESP术是一种微创、安全有效的治疗方法。

参考文献/References:

[1] Takayama T, Miyata T, Shirakawa M, et al. Isolated spontaneous dissection of the splanchnic arteries[J]. J Vasc Surg, 2008, 48: 329-333.
[2] Glehen O, Feugier P, Aleksic Y, et al. Spontaneous dissection of the celiac artery[J]. Ann Vasc Surg, 2001, 15: 687-692.
[3] 许永乐, 熊 江, 郭 伟, 等. 孤立性肠系膜上动脉夹层的治疗策略[J]. 介入放射学杂志, 2010, 19: 694-697.
[4] Ozturk TC, Yaylaci S, Yesil O, et al. Spontaneous isolated celiac artery dissection[J]. J Res Med Sci, 2011, 16: 699-702.
[5] Takach TJ, Madjarov JM, Holleman JH, et al. Spontaneous splanchnic dissection: Application and timing of therapeutic options[J]. J Vasc Surg, 2009, 50: 557-563.
[6] 陈则君, 孟宪平, 王伯元. 自发性孤立性肠系膜上动脉夹层治疗进展[J]. 介入放射学杂志, 2012, 21: 696-699.
[7] Lim EH, Jung SW, Lee SH, et al. Endovascular management for isolated spontaneous dissection of the superior mesenteric artery: report of two cases and literature review[J]. J Vasc Interv Radiol, 2011, 22: 1206-1211.
[8] Jibiki M, Inoue Y, Kudo T. Conservative treatment for isolated superior mesenteric artery dissection[J]. Surg Today, 2013, 43: 260-263.
[9] Vaidya S, Dighe M. Spontaneous celiac artery dissection and its management[J]. J Radiol Case Rep, 2010, 4: 30-33.
[10] Park YJ, Park KB, Kim DI, et al. Natural history of spontaneous isolated superior mesenteric artery dissection derived from follow-up after conservative treatment[J]. J Vasc Surg, 2011, 54: 1727-1733.
[11] Casella IB, Bosch MA, Sousa WO Jr. Isolated spontaneous dissection of the superior mesenteric artery treated by percut-aneous stent placement: case report[J]. J Vasc Surg, 2008, 47:197-200.
[12] Ozaki N, Wakita N, Yamada A, et al. Spontaneous dissection of the splanchnic arteries[J]. Interact Cardiovasc Thorac Surg, 2010, 10: 656-658.
[13] Casella IB, Bosch MA, Sousa J. Isolated spontaneous dissection of the superior mesenteric artery treated by percutaneous stent placement: Case report[J]. J Vasc Surg, 2008, 47: 197-200.
[14] Solis MM, Ranval TJ, McFarland DR, et al. Surgical treatment of superior mesenteric artery dissecting aneurysm and simultaneous celiac artery compression[J]. Ann Vasc Surg, 1993, 7: 457-462.
[15] Allen RC, Martin GH, Rees CR, et al. Mesenteric angioplasty in the treatment of chronic intestinal ischemia[J]. J Vasc Surg, 1996, 24: 415-421.
[16] Sparks SR, Vasquez JC, Bergan JJ, et al. Failure of nonoperative management of isolated superior mesenteric artery dissection[J]. Ann Vasc Surg, 2000, 14: 105-109.
[17] Bauersfeld SR. Dissecting aneurysm of the aorta; a presentation of 15 cases and a review of the recent literature[J]. Ann Intern Med, 1947, 26: 873-889.
[18] Verde F, Bleich KB, Oshmyansky A, et al. Isolated celiac and superior mesenteric artery dissection identified with MDCT: imaging findings and clinical course[J]. J Comput Assist Tomogr, 2012, 36: 539-545.
[19] D’Ambrosio N, Friedman B, Siegel D, et al. Spontaneous isolated dissection of the celiac artery: CT findings in adults[J]. AJR Am J Roentgenol, 2007, 188: W506-W511.
[20] Jung SC, Lee W, Park EA, et al. Spontaneous dissection of the splanchnic arteries: CT findings, treatment, and outcome[J]. AJR Am J Roentgenol, 2013, 200: 219-225.
[21] Leung DA, Schneider E, Kubik-Huch R, et al. Acute mesenteric ischemia caused by spontaneous isolated dissection of the superior mesenteric artery: treatment by percutaneous stent placement[J]. Eur Radiol, 2000, 10: 1916-1919.
[22] Pang P, Jiang Z, Huang M, et al. Value of endovascular stent placement for symptomatic spontaneous isolated superior mesenteric artery dissection[J]. Eur J Radiol, 2013, 82: 490-496.
[23] Chu SY, Hsu MY, Chen CM, et al. Endovascular repair of spontaneous isolated dissection of the superior mesenteric artery[J]. Clin Radiol, 2012, 67: 32-37.
[24] Min SI, Yoon KC, Min SK, et al. Current strategy for the treatment of symptomatic spontaneous isolated dissection of superior mesenteric artery[J]. J Vasc Surg, 2011, 54: 461-466.
[25] Zhang XC, Sun Y, Chen ZL, et al. Therapeutic regimen options for isolated superior mesenteric artery dissection[J]. Vasc Endovascular Surg, 2012, 46: 277-282.
[26] Yun WS, Kim YW, Park KB, et al. Clinical and angiographic follow-up of spontaneous isolated superior mesenteric artery dissection[J]. Eur J Vasc Endovasc Surg, 2009, 37: 572-577.
[27] Kim JH, Roh BS, Lee YH, et al. Isolated spontaneous dissection of the superior mesenteric artery: percutaneous stent placement in two patients[J]. Korean J Radiol, 2004, 5: 134-138.
[28] 任建庄, 张萌帆, 张 凯, 等. Wallstent双支架重叠技术治疗复杂内脏动脉瘤五例[J]. 介入放射学杂志, 2014, 23: 1036-1040.
[29] 陈跃鑫, 刘昌伟, 刘 暴. 孤立性肠系膜上动脉夹层的病例荟萃分析[J]. 中华医学杂志, 2008, 88: 3345-3348.
[30] Oda T, Ono H, Muranaka H, et al. The right gastroepiploic artery as an alternative inflow source in acute mesenteric ischemia[J]. J Vasc Surg, 2005, 41: 1061-1064.
[31] Picquet J, Abilez O, Pénard J, et al. Superficial femoral artery transposition repair for isolated superior mesenteric artery dissection[J]. J Vasc Surg, 2005, 42: 788-791.
[32] Morris JT, Guerriero J, Sage JG, et al. Three isolated superior mesenteric artery dissections: Update of previous case reports, diagnostics, and treatment options[J]. J Vasc Surg, 2008, 47: 649-653.

备注/Memo

备注/Memo:
(收稿日期:2014-12-01)
(本文编辑:边 佶)
更新日期/Last Update: 2015-07-22