穿透性主动脉粥样硬化性溃疡1例报告并文献复习

Penetrating atherosclerotic ulcer: a case report and review of literature

目的:了解穿透性动脉粥样硬化性溃疡的临床特征、诊断和治疗。方法:对1例穿透性动脉粥样硬化性溃疡患者的临床资料进行分析,并复习相关文献。结果:1例患者临床表现为晕厥起病,其后出现低血压、胸闷、浆膜腔积液及胸痛,64排CT主动脉血管成像及三维重建图像示升主动脉穿透性动脉粥样硬化性溃疡伴壁内血肿形成,手术放置血管内支架后症状消失。结论:穿透性动脉粥样硬化性溃疡的临床表现多样,CT血管成像是有效的诊断手段,临床表现明显者应尽早手术治疗。

Objective：To explore the clinical manifestations,diagnosis and treatment of penetrating atherosclerotic ulcer.Methods：We report the clinical data of a case with penetrating atherosclerotic ulcer and reviewed the related literature.Results：Syncope was the first clinical manifestation of the patient,and followed with hypotension,chest tightness,serous membrane fluid,chest pain.64-slice spiral CT aortic angiography and the reconstruction of 3D aortic angiograph display penetrating atherosclerotic ulcer and intramural hematoma.The patient was cured after surgical treatment with application of self-expanding stent.Conclusion： Clinical manifestations of penetrating atherosclerotic ulcer are various.CTA is important for diagnosis.Early surgical treatment is needed for those with obvious clinical manifestations.