腹腔动脉重度狭窄的影像学表现及经肝动脉介入治疗中的应对策略

Imaging appearances and coping strategies for hepatic arterial interventional procedures of severe celiac artery stenosis

目的分析腹腔动脉重度狭窄的CTA及DSA表现,探讨对该类患者行经肝动脉介入治疗的应对策略。方法回顾分析11例经腹部CTA和腹腔动脉-肠系膜上动脉DSA确诊的腹腔动脉重度狭窄患者,评估其腹腔动脉狭窄的原因、程度,侧支循环和介入手术的处理。结果 11例患者腹腔动脉狭窄均为中弓韧带压迫所致,均有明显的侧支循环形成;对其中10例采用不同方法成功进行了经肝动脉介入治疗。结论行经肝动脉介入治疗腹腔动脉狭窄时,适宜的应对策略具有重要临床意义。术前腹部CTA对于该类患者的后续治疗有重要指导价值。

Objective To analyze the imaging appearances of severe celiac artery stenosis （CAS） on CTA and DSA, and to investigate coping strategies for hepatic arterial interventional procedures of this disease. Methods Eleven patients with severe CAS diagnosed with abdominal CTA and celiac artery-superior mesenteric artery DSA were retrospectively analyzed. The causes, degree, collateral circulations of CAS and approaches in interventional procedures were accessed. Results All patients had severe CAS and apparently collateral circulations due to compression of median arcuate ligament （MAL）, and 10 patients processed hepatic arterial therapies with different methods successfully. Conclusion Appropriate coping strategies for hepatic arterial interventional procedures have great significances in CAS therapies. Preoperative abdominal CTA has guiding value for the management of CAS.