Carr S C, Mahvi D M, Hoch J R, Archer C W, Turnipseed W D
University of Wisconsin, Health Sciences Center, Madison, USA.
J Vasc Surg. 2001 Apr;33(4):806-11. doi: 10.1067/mva.2001.112320.
Aneurysms of the visceral arteries are infrequently encountered. Many are found incidentally and are thought to have a benign outcome. To better characterize these lesions and their clinical course, we reviewed our experience with visceral artery aneurysms (VAAs) at a single institution.
A retrospective analysis of all VAAs diagnosed at our institution over the past 10 years was performed. The presentation, management, and outcome of therapy was examined for each patient.
Thirty-four VAAs in 26 patients were diagnosed over the past 10 years. Four patients had multiple VAAs: splenic (17), hepatic (7), celiac (3), superior mesenteric (2), gastroduodenal (2), pancreaticoduodenal (1), right gastric (1), ileal (1) artery aneurysms. Associated aneurysms were found in 31% of patients and involved the thoracic aorta (3 patients), abdominal aorta (4 patients), renal arteries (2 patients), iliac artery (3 patients), lower extremity (1 patient), and intracranium (1 patient). In 15 patients (58%), VAAs were detected before rupture by chance or because abdominal symptoms resulted in diagnostic evaluation. Eight of these underwent elective surgery, and there were no deaths. Of those 15 patients with known VAAs, one patient died of rupture and hemorrhage from an untreated splenic artery aneurysm. Eleven patients (42%) presented unexpectedly with rupture, and two died despite prompt surgical treatment. The mortality rate in patients who had ruptured VAAs was 25%, including those who presented with ruptured aneurysms and those observed whose aneurysms eventually ruptured.
Aneurysms of the visceral arteries are rare but important vascular lesions. Associated aneurysms are common. Because of the risk of rupture, often with a fatal outcome, an aggressive approach to the treatment of VAA is essential.
内脏动脉动脉瘤较少见。许多是偶然发现的，且被认为预后良好。为了更好地描述这些病变及其临床过程，我们回顾了在单一机构中内脏动脉动脉瘤（VAA）的诊治经验。
对过去10年在本机构诊断的所有VAA进行回顾性分析。检查了每位患者的临床表现、治疗方法及治疗结果。
过去10年共诊断出26例患者的34个VAA。4例患者有多个VAA：脾动脉（17个）、肝动脉（7个）、腹腔干（3个）、肠系膜上动脉（2个）、胃十二指肠动脉（2个）、胰十二指肠动脉（1个）、右胃动脉（1个）、回肠动脉（1个）动脉瘤。31%的患者发现有相关动脉瘤，累及胸主动脉（3例）、腹主动脉（4例）、肾动脉（2例）、髂动脉（3例）、下肢（1例）和颅内（1例）。15例患者（58%）在动脉瘤破裂前因偶然因素或腹部症状进行诊断评估时被发现。其中8例接受了择期手术，无死亡病例。在这15例已知VAA的患者中，1例患者死于未治疗的脾动脉动脉瘤破裂出血。11例患者（42%）意外出现破裂，尽管及时手术治疗仍有2例死亡。VAA破裂患者的死亡率为25%，包括那些出现动脉瘤破裂的患者以及观察到动脉瘤最终破裂的患者。
内脏动脉动脉瘤虽罕见但为重要的血管病变。相关动脉瘤很常见。由于存在破裂风险，且常导致致命后果，积极治疗VAA至关重要。
