孤立性肠系膜上动脉夹层的影像学诊断和治疗
Imaging diagnosis and treatment of isolated superior mesenteric artery dissection
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摘要: 孤立性肠系膜上动脉夹层是临床上的少见病，该病的治疗目前尚无统一方案。本研究回顾性分析2011年4月至2012年1月扬州大学临床医学院收治的3例孤立性肠系膜上动脉夹层患者的临床资料，旨在探讨该病的影像诊断和治疗效果。3例患者经过保守治疗后腹痛症状缓解不明显甚至加重，行血管腔内裸支架植入术治疗,术后继续给予抗凝、抗血小板治疗。3例患者支架腔内重建术均获成功，共植入7个裸支架；植入支架后患者的腹痛症状有不同程度减轻，3d后腹痛均消失。复查CT血管重建肠系膜上动脉内支架位置良好，支架腔内血流通畅，夹层及假腔消失。Abstract: Isolated superior mesenteric artery dissection (ISMAD) is rarely seen in clinical practice, and its treatment has not been standardized. The clinical data of 3 patients with ISMAD who were admitted to the Yangzhou University from April 2011 to January 2012 were retrospectively analyzed to investigate the imaging diagnosis and treatment of this disease. All the 3 patients received conservative treatment, but the abdominal pain was not alleviated or even worsened, and then they received percutaneous endovascular reconstruction with bare stent implantation. Antiplatelet therapy and anticoagulation after stent placement were given to the 3 patients after stent placement. Seven bare stents were implanted. The abdominal pain was alleviated and disappeared gradually within 3 days. Computed tomography angiography showed complete resolution of the dissection and false lumen with sufficient flow of in stent and superior mesenteric artery.Percutaneous endovascular reconstruction with bare stent implantation is a effective and reliable treatment method for ISMAD.
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