腔内治疗自发孤立性肠系膜上动脉夹层单中心经验  

Endovascular treatment for patients with spontaneous isolated superior mesenteric artery dissection :single-center experiences

作　　者：杨睿 贾贺月 刘小平[1] 贾鑫[1] 马晓辉[1] 张宏鹏[1] 陈月英 郭伟[1] 熊江[1] Yang Rui;Jia Heyue;Liu Xiaoping;Jia Xin;Ma Xiaohui;Zhang Hongpeng;Chen Yueying;Guo Wei;Xiong Jiang(Department of Vascular and Endovascular Surgery,the First Medical Center,Chinese PLA General Hospital,Beijing 100853,China;Department of Vascular Surgery,the First Hospital of Yun Cheng,Shanxi Province 044000,China;Medical School of Chinese PLA,Beijing 100853,China)

机构地区：[1]解放军总医院第一医学中心血管外科,北京100853 [2]运城市第一医院血管外科,山西省044000 [3]解放军医学院,北京100853

出　　处：《中华普通外科杂志》2021年第3期174-177,共4页Chinese Journal of General Surgery

摘　　要：目的总结腔内治疗自发孤立性肠系膜上动脉夹层(spontaneous isolated superior mesenteric artery dissection,SISMAD)的中远期结果。方法回顾性分析解放军总医院2011年1月至2019年12月收治并接受腔内治疗的31例SISMAD患者的临床资料。结果29例SISMAD患者达到成功治疗的目的,技术成功率93.5%,28例患者植入自膨式裸支架共36枚,1例仅行单纯球囊扩张术。支架术后89.3%的病例腹痛消失时间<24 h,围手术期并发症率3.2%。术后随访时间6〜110个月,中位随访时间53.5个月。1、3、5年的腔内治疗后免于再干预率分别为100%、100%及91.7%。结论依据一定的指征对部分症状型SISMAD实施腔内治疗安全有效。Objective To summarize the midterm to long-term outcomes and experiences of endovascular treatment(ET)of spontaneous isolated superior mesenteric artery dissection(SISMAD).Methods The clinical data of 31 SISMAD patients from Jan 2011 to Dec 2019 treated with ET was retrospectively analyzed.Results Successful ET was achieved in 29 patients with a technical success rate of 93.5%.A total of 36 self-expandable bare stents were planted in 28 patients and plain old balloon angioplastry(POBA)was performed in 1 patient.Abdominal pain disappeared within 24 hours in 89.3%of the patients after stenting.The rate of perioperative complication was 3.2%.There was no SMA dissection rupture bleeding,nor perioperative death occurred.The mean follow-up time was 53.5(range,6 to 110)months.There was no dissecting aneurysm formation,no SMA rupture and bleeding,and no stent rupture during the follow-up.The post ET 1-year,3-year,and 5-year free from reintervention rate were 100%,100%,and 91.7%,respectively.Conclusions ET for SISMAD is safe and effective with satisfactory perioperative and midterm to long-term outcomes.

关 键 词：肠系膜上动脉 支架 夹层 腔内治疗 

分 类 号：R572.3[医药卫生—消化系统]