双层裸支架及覆膜支架治疗肠系膜上动脉夹层  

Double-layer bare stent and covered stent in the treatment of superior mesenteric artery dissection

作　　者：王洋[1] 韩新巍[1] 周朋利[1] 张文广[1] 徐苗[1] 刘超[1] 李磊[1] WANG Yang;HAN Xinwei;ZHOU Pengli;ZHANG Wenguang;XU Miao;LIU Chao;LI Lei(Department of Interventional Radiology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院介入放射科,河南郑州450052

出　　处：《实用放射学杂志》2022年第11期1859-1863,共5页Journal of Practical Radiology

摘　　要：目的评估不同血管内支架治疗孤立性肠系膜上动脉夹层(ISMAD)的疗效及安全性.方法回顾性选取62例ISMAD患者,分析其临床特征、手术疗效及随访结果.分析比较使用覆膜支架和双层裸支架在手术时间、术后住院时间、术后并发症、症状复发率、二期手术率、支架通畅率、死亡率方面的差异.结果62例患者中8例接受保守治疗,其余行支架置入术,手术成功率98.1%(53/54),支架组症状缓解率及夹层重塑率明显高于保守治疗者(P<0.05).其中22例应用覆膜支架,21例应用双层裸支架,10例应用单层裸支架.覆膜支架组手术时间、术后住院时间小于双层裸支架组(P<0.05);2组术后并发症发生率、症状复发率、二期手术率、支架通畅率、死亡率无明显差异(P>0.05).结论覆膜支架及双层裸支架血管内介入治疗ISMAD在短中期均有效且安全,可依据指征选择不同的支架.Objective To evaluate the efficacy and safety of different endovascular stents in the treatment of isolated superior mesenteric artery dissection(ISMAD).Methods Sixty-two patients with ISMAD were retrospectively selected,and their clinical features,surgical effects,and follow-up results were analyzed.The differences in the operation time,postoperative hospital stay,postoperative complications,symptom recurrence rate,second-stage operation rate,stent patency rate,and mortality rate between covered stent and double-layer bare stent were analyzed and compared.Results 8 of the 62 patients received conservative treatment,and the remaining patients underwent stent placement.The operation success rate was 98.1%(53/54).The rate of symptom relief and dissection remodeling in the stent group was significantly higher than that of conservative treatment.Among them,22 cases used covered stents,21 cases used double-layer bare stents,and 10 cases used single-layer bare stents.The operation time and postoperative hospital stay in the covered stent group were shorter than those in the double-layer bare stent group;there was no significant difference in postoperative complications rate,symptom recurrence rate,second-stage operation rate,stent patency rate,and mortality rate between the two groups(P>0.05).Conclusion Endovascular therapy of ISMAD with covered stent and the double-layer bare stent is effective and safe in the short and medium-term.Different stents can be selected according to the indications.

关 键 词：肠系膜上动脉 夹层 腔内治疗 

分 类 号：R815[医药卫生—放射医学] R572.3[医药卫生—临床医学]