孤立性肠系膜上动脉夹层分型及治疗策略

The classification and management strategy of isolated superior mesenteric artery dissection

随着计算机断层扫描技术的发展,孤立性肠系膜上动脉夹层(ISMAD)检出率越来越高。多种ISMAD分型方案相继提出,主要依据为真腔和假腔影像学表现、真腔通畅情况、夹层累及范围,但目前尚无临床上广泛认可的分型方案。现有分型方案中,Yoo等提出的分型相比其它分型较为全面。国内外主要治疗策略包括保守治疗、血管腔内治疗、开放手术治疗,对不同分型采用不同治疗方法,但目前缺乏统一治疗规范。本文就ISMAD分型方案和治疗策略作一综述。

With the development of computed tomography technology, the detection rate of isolated superior mesenteric artery dissection (ISMAD) is getting higher and higher. A variety of ISMAD classification schemes have been proposed one after another. These classification schemes are mainly based on the imaging manifestations such as true and false lumen, the patency of true lumen and the involved extent of dissection. However, there is no classification scheme that can be widely accepted in clinical practice so far. Among the existing classification schemes, the classification scheme proposed by Yoo, et al. is more comprehensive than other classification schemes. The main treatment strategies for ISMAD at home and abroad include conservative treatment, endovascular treatment and open surgical treatment, and different treatment methods are adopted for different types of ISMAD. But there is still lack of unified treatment standards in clinical practice. This article aims to make a comprehensive review of the classification and treatment strategies of ISMAD.