腔内支架技术治疗自发性孤立性肠系膜上动脉夹层

Endovascular Stent Placement for Spontaneous Isolated Dissection of Superior Mesenteric Artery

目的探讨腔内支架技术治疗自发性孤立性肠系膜上动脉夹层（spontaneous isolated dissection of superior mesenteric artery，SIDSMA）的安全性及有效性。方法回顾性分析2009年1月～2011年4月16例接受血管腔内支架治疗的SIDSMA的临床资料。结果均手术顺利，12例行单层裸支架释放，4例行双层裸支架释放。术后腹痛症状改善15例，无变化1例。术后6个月CTA复查，16例均支架通畅，14例假腔消失，2例支架外造影剂显影。结论对于未合并夹层破裂出血、肠坏死的症状性SIDSMA，腔内支架治疗是一种安全、有效、微创的治疗选择。

Objective To discuss the efficacy and safety of endovascular treatment of spontaneous isolated dissection of superior mesenteric artery （SIDSMA） with stent. Methods A retrospective review of 16 patients undergoing endovascular treatment of SIDSMA from January 2009 to April 2011 was concluded. Results All the 16 surgeries were successful, with 12 cases of single stent and 4 cases of overlapping stents. Abdominal pain was relieved in 15 cases and no improvement was observed in 1 case after the surgery, Computed tomography angiography （CTA） 6 months postoperatively revealed stent patency in 16 cases, thrombus formation in the false lumen in 14 cases, and contrast enhancement outside the stent in 2 cases. Conclusion Endovascular stent placement is a safe and efficient surgical procedure for the treatment of symptomatic SIDSMA without intra-abdominal hemorrhage and intestinal infarction.