Pulsar-18支架治疗自发性孤立性肠系膜上动脉夹层的中期疗效  

Mid-term efficacy of Pulsar-18 stent in treatment of spontaneous isolated superior mesenteric artery dissection

作　　者：朱涛 张琳[1] 曾玺 张伟[1] 张新千 李凤贺[1] Zhu Tao;Zhang Lin;Zeng Xi;Zhang Wei;Zhang Xinqian;Li Fenghe(Department of Vascular Surgery,The First Affiliated Hospital of Chongqing Medical University)

机构地区：[1]重庆医科大学附属第一医院血管外科,重庆400016

出　　处：《重庆医科大学学报》2025年第4期536-540,共5页Journal of Chongqing Medical University

摘　　要：目的:回顾性分析应用Pulsar-18支架治疗自发性孤立性肠系膜上动脉夹层(spontaneous isolated dissection of superior mesenteric artery,SIDSMA)的中期疗效。方法:回顾性分析了自2019年4月至2021年3月应用Pulsar-18支架治疗的SIDSMA患者的数据。收集患者的性别、年龄、基础疾病、影像学特征等基本信息,记录随访期内患者临床症状的改善情况、支架通畅率和血管重塑情况。结果:该研究纳入了45例患者,其中男性41例,女性4例。患者年龄为45~72岁,高血压患者的比例为48.89%(22/45)。手术成功率100%。45名病人共置入63枚支架,支架直径5~7 mm。围手术期无支架急性血栓等并发症。穿刺点血肿发生概率0%。支架置入3个月、6个月、1年、2年的通畅率均为100%;血管完全重塑率分别为64.4%、82.2%、82.2%和86.7%。1例患者术后第5个月因十二指肠溃疡出现血便,病因,经内镜止血后痊愈。其他患者在2年内无腹痛复发、无新发动脉瘤、无假腔增大。结论:Pulsar-18支架置入术是治疗SIDSMA的1种有效的治疗措施,能提供高血管完全重塑率,并在中期随访内有良好的通畅率。Objective:To investigate the mid-term efficacy of Pulsar-18 stent in the treatment of spontaneous isolated superior mesenteric artery dissection(SIDSMA) through a retrospective analysis.Methods:A retrospective analysis was performed for the data of patients with SIDSMA who received treatment with Pulsar-18 stent from April 2019 to March 2021.Basic information was collected,such as sex,age,underlying disease,and radiological features,and the patients were observed in terms of the improvement in clinical symptoms,stent patency rate,and vascular remodeling during follow-up.Results:A total of 45 patients were included in this study,with 41male patients and 4 female patients.The patients had an age of 45-72 years,and the patients with hypertension accounted for 48.89%(22/45).The surgical success rate was 100%.A total of 63 stents were placed for the 45 patients,with a stent diameter ranging from 5mm to 7 mm.There were no perioperative complications such as acute thrombosis of the stent,and the probability of hematoma at the puncture point was 0%.The stent patency rate was 100% at 3 months,6 months,1 year,and 2 years after stent placement,and the complete vascular remodeling rate was 64.4%,82.2%,82.2%,and 86.7%,respectively.One patient developed bloody stool at 5 months after surgery and was diagnosed with duodenal ulcer,and the patient fully recovered after endoscopic hemostasis.The other patients had no recurrent abdominal pain,new-onset aneurysms,or enlargement of the false lumen within 2 years.Conclusion:Pulsar-18 stent placement is an effective treatment method for SIDSMA and can provide a high rate of complete vascular remodeling,with a high pa- tency rate during mid-term follow-up.

关 键 词：自发性孤立性肠系膜上动脉夹层 腔内治疗 血管完全重塑率 血管部分重塑率 通畅率 

分 类 号：R543.7[医药卫生—心血管疾病]