自发性孤立性肠系膜上动脉夹层的血管内支架治疗.doc

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1、自发性孤立性肠系膜上动脉夹层的血管内支架治疗［摘要］目的探讨血管内支架治疗自发性孤立性肠系膜上动脉夹层(SISMAD)的价值。方法回顾性分析2008年1月〜2014年11月江苏大学附属武进人民医院收治并行血管内支架治疗的10例SISMAD患者的临床资料及随访结果，参照Sakamoto血管影像学分型，II型4例，III型6例，探讨血管内支架治疗SISMAD的可行性和效果。结果10例患者均成功植入血管内支架；术后10例患者腹痛症状均缓解；1例患者出现肠系膜上动脉远端分支破裂出血，予不锈钢圈栓塞，余无严重并发症。随访6〜3

2、6个月，平均26个月，患者无再发腹痛症状，增强CT显示所有患者肠系膜上动脉支架内血流通畅，夹层愈合。结论血管内支架治疗II、III型SISMAD是一种有效、安全的方法。［关键词］肠系膜上动脉；夹层；孤立性；支架［中图分类号］R657.2［文献标识码］A［文章编号］1673-7210(2016)10(a)-0052-04EndovascularstentplacementforspontaneousisolatedsuperiormesentericarterydissectionSHENTaoHUANGYouhuaS

3、HIHongjianXUQiangSONGQianXUYuanfenDepartmentofVascularandInterventionalRadiology,WujinPeople'sHospitalAffiliatedtoJiangsuUniversity,JiangsuProvince,Changzhou213002,China[Abstract]ObjectiveTodiscussthevalueofendovascularstentplacementforspontaneousisolatedsuperi

4、ormesentericarterydissection(SISMAD).MethodsTheclinicaldataof10patientswithSISMAD,whowereadmittedtoWujinPeople'sHospitalAffiliatedtoJiangsuUniversitytoreceiveendovascularstentplacementduringtheperiodfromJanuary2008toNovember2014,wereretrospectivelyanalyzed.Acco

5、rdingtoSakamotoangiographiccategorization,4caseswereclassifiedastype11and6caseswereclassifiedastypeIII.ThefeasibilityandefficacyofendovascularstentforSISMADwereevaluated.ResultsAll10patientsunderwentsuccessfullyendovascularstentplacement,andallofthemgotarelease

6、ofabdominalpainafteroperation.Onepatient'sdistalbranchofsuperiormesentericartery(SMA)wasrupturedwithbleeding,andwascuredwithcoilembolization.Nootherseriouscomplicationsoccurred.Allpatientswerefollowed-upfor6-36months,averageof26months,norecurrenceofabdominalpai

7、n.EnhancedCTexaminationshowedcompleteresolutionofthedissectionandallstentinSMApatent.ConclusionEndovasculartreatmentisaneffectiveandfeasibletherapeuticapproachfortypeIIandIIIofSISMAD.[Keywords]Superiormesentericartery；Dissection；Isolated；Stent自发性孤立性肠系膜上动脉夹层（spo

8、ntaneousisolatedsuperiormesentericarterydissection,SISMAD）曾被认为是一种临床罕见的疾病，随着多层螺旋CT血管成像（MSCTA）及MR血管成像（MRA）的广泛应用，近年来，国内关于SISMAD的报道明显增加[1-2]。但是SISMAD病因尚不清楚，至今仍然没有统一的治疗规范[3-6]o江苏