经腹腔干-胃十二指肠弓逆向介入治疗肠系膜上动脉开口处完全闭塞无残端病变1例

发布时间：2018-05-06 13:58

本文选题：肠系膜血管闭塞 + 肠系膜上动脉　；参考：《中国普通外科杂志》2017年06期

【摘要】：目的:探讨逆向入路支架植入治疗肠系膜上动脉(SMA)闭塞的技术。方法:回顾2017年2月1例于复旦大学附属中山医院血管外科行逆向开通SMA闭塞的患者临床资料。结果:患者为47岁女性,诊断为SMA闭塞引起的慢性肠系膜缺血(CMI),行腔内治疗再通SMA。由于SMA开口处完全闭塞性,无残端,经肱动脉和股动脉双侧入路均无法开通病变部位。利用腹腔干和SMA之间的胃十二指肠弓,通过此通路逆向开通SMA闭塞处;肱动脉入路导管和导丝对接后顺利正向通过病变,完成球囊扩张和支架植入术。术后患者CMI症状消失,3个月后随访CTA显示,支架定位良好,远端血管通畅。结论:对于常规血管内介入治疗方法失败的SMA闭塞患者,通过有效的侧支通路进行逆行开通是可行的。
[Abstract]:Objective: to investigate the treatment of superior mesenteric artery (SMA) occlusion with reverse stent implantation. Methods: the clinical data of a patient with SMA obliteration underwent reverse operation in Zhongshan Hospital affiliated to Fudan University in February 2017 were retrospectively reviewed. Results: the patient was 47 years old and diagnosed as chronic mesenteric ischemia caused by SMA occlusion. Because of the complete occlusion of the opening of SMA and no stump, bilateral approach of brachial artery and femoral artery could not open the lesion. The gastroduodenal arch between the celiac trunk and SMA was used to reverse open the occlusion of SMA, and the brachial artery catheter and guide wire were connected smoothly through the lesion to complete balloon dilation and stent implantation. The symptoms of CMI disappeared after operation. The CTA showed that the stents were well located and the distal vessels were patency. Conclusion: it is feasible for patients with SMA occlusion who have failed in routine endovascular interventional therapy to open retrograde via an effective collateral pathway.
【作者单位】：复旦大学附属中山医院血管外科/复旦大学附属血管外科研究所;山东省枣庄市人民医院血管外科;
【基金】：国家自然科学基金资助项目(81570438)
【分类号】：R657.2

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