裸支架成形术治疗症状性自发孤立肠系膜上动脉夹层的中远期疗效观察  

Observation of the Mid-and Long-Term Curative Effect of Bare Stent Angioplasty in the Treatment of Symptomatic Spontaneous Isolated Superior Mesenteric Artery Dissection

作　　者：耿金宝 王兵[1] 王越 王颖[1] 何超杰 GENG Jinbao;WANG Bing;WANG Yue(Department of Vascular Surgery,The Fifth Affiliated Hospital of Zhengzhou Univesity,Zhengzhou,Henan Province 450052,P.R.China)

机构地区：[1]郑州大学第五附属医院血管外科,450052

出　　处：《临床放射学杂志》2022年第3期557-561,共5页Journal of Clinical Radiology

基　　金：河南省卫生计生科技创新型人才“51282”工程项目(编号:201632)。

摘　　要：目的评价裸支架成形术治疗症状性自发孤立性肠系膜上动脉夹层(SISMAD)的中远期疗效。方法回顾性分析使用裸支架成形术治疗症状性SISMAD 29例患者的临床资料。结果29例患者手术均获得了成功,技术成功率为100%,其中24例植入单层裸支架,5例植入双层裸支架。术后24 h内腹痛症状明显缓解或消失(NRS评分6.2±1.3 vs.2.0±0.8,P<0.05),肠系膜上动脉真腔受压程度较术前有显著改善[(80.7±5.9)%vs.(1.8±0.8)%,P<0.05]。术后随访时间12~100个月,中位随访时间60个月,1、3和5年的累积一期通畅率分别为100%、95.2%和88.9%。结论裸支架成形术治疗症状性SISMAD技术成功率高,可缓解腹痛症状及肠系膜上动脉真腔受压程度,中远期愈后较好。Objective To evaluate the medium and long-term efficacy of bare stent angioplasty in the treatment of symptomatic spontaneous isolated superior mesenteric artery dissection(SISMAD).Methods A retrospective analysis of the clinical data of 29 patients with symptomatic SISMAD treated with bare stent angioplasty in our hospital from June 2011to June 2020.Results The operations of 29 patients were successful,and the technical success rate was 100%.Among them,24 patients were implanted with a single-layer bare stent and 5 patients were implanted with a double-layer bare stent.Abdominal pain symptoms were significantly relieved or disappeared within 24 hours after operation(NRS score 6.2±1.3vs.2.0±0.8,P<0.05),and the compression of SMA’s true cavity was significantly improved compared with preoperative[(80.7±5.9)%vs.(1.8±0.8)%,P<0.05].The postoperative follow-up time was 12 to 100 months,and the median follow-up time was 60 months.The cumulative primary patency rates of 1,3,and 5 years were 100%,95.2%,and 88.9%,respectively.Conclusion Bare stent angioplasty has a high success rate in the treatment of symptomatic SISMAD,which can relieve the symptoms of abdominal pain and the degree of compression of the true cavity of SMA,and it has a better long-term recovery.

关 键 词：自发孤立肠系膜上动脉夹层 裸支架成形术 中远期疗效 

分 类 号：R654.3[医药卫生—外科学]