裸支架治疗症状性肠系膜上动脉夹层中长期疗效观察

The efficacy of mid-long time follow-up for symptomatic superior mesenteric artery dissection treated with bare stent

目的中长期随访观察血管腔内裸支架植入术治疗症状性肠系膜上动脉夹层(SDSMA)的疗效。方法回顾性分析8例接受血管内支架植入术的SDSMA(Yun血管影像学分型方法:Ⅰ型3例,Ⅱa型4例,Ⅱb型1例)患者资料。8例患者均行肠系膜上动脉裸支架植入术,术后以抗凝或终身抗血小板治疗。术后6个月、1年、2年行CTA复查,显示支架内血流通畅,动脉夹层消失。结果 8例患者共植入自膨式裸支架11枚,其中单支架5例,双支架3例。术后造影显示肠系膜上动脉病变段假腔未显影或显影较淡,真腔血流通畅,手术成功率100%。8例患者术后平均随访32个月,期间均无腹痛、腹胀及消化道出血症状。结论血管腔内裸支架植入术治疗症状性肠系膜上动脉夹层安全、有效,中长期效果满意。

Objective To evalute the mid-long time efficacy ofendovascular treatment with bare stent for symptomatic superior mesenteric artery dissection(SDSMA).Methods Data of 8 cases with SDSMA inchuded 3 cases of typeⅠ,4 cases of typeⅡa and 1 case ofⅡb according to the Yun Angiographic Classification.All the 8 patients received the bare stent angioplasty under the digital subtraction angiography(DSA).Antiplatelet therapy and anticoagulation were performed in all the cases after stent placement.Results A total of 11 bare self-expanding stents were used in 8 patients,including one-layer in 5 cases and double stent placement in 3 patients.Repeated angiography after the procedure showed false lumen of superior mesenteric artery was rated as none or minimaland the true lumen with sufficient distal flow of the SMA were obtained.The technical success rate was 100%.No symptoms of abdominal pain,abdominal distension and gastrointestinal bleeding occurred in the mean followed up period of for 32 months.Conclusion Percutaneous endovascular treatment with bare stent placement is safe and effective for SDSMA,and its long-term effect is satisfactory.