Soga Yoshimitsu, Yokoi Hiroyoshi, Iwabuchi Masashi, Nobuyoshi Masakiyo
Department of Cardiology, Kokura Memorial Hospital, Kitakyushu, Japan.
Circ J. 2008 Jul;72(7):1198-200. doi: 10.1253/circj.72.1198.
Endovascular procedure is frequently used as an alternative to surgical bypass in aortic atherosclerotic lesions. Two rare cases of chronic mesenteric ischemia treated with a stent implantation are reported. The patients were a 72-year-old woman and a 57-year-old woman. They presented with severe abdominal pain after meals, repeatedly. Angiography revealed severe stenosis and occlusion of the super mesenteric artery (SMA). Endovascular treatment was initially and technically successful in both patients. A Palmaz stent was deployed in the ostium lesion of the SMA for both cases. Completion angiography showed successful recanalization of the SMA without any complication and with satisfactory distal flow. The patients' symptoms were alleviated. They remained asymptomatic after stent implantation. Primary stenting may be considered a viable alternative to conventional surgery in carefully selected patients with chronic mesenteric ischemia due to SMA stenosis.
血管内介入治疗常被用作主动脉粥样硬化病变手术搭桥的替代方法。本文报道了两例采用支架植入术治疗的慢性肠系膜缺血罕见病例。患者为一名72岁女性和一名57岁女性。她们均反复出现餐后严重腹痛。血管造影显示肠系膜上动脉（SMA）严重狭窄和闭塞。两名患者的血管内治疗最初在技术上均获成功。两例均在SMA开口病变处植入了帕尔马兹支架。造影剂注入完成后的血管造影显示SMA成功再通，无任何并发症，远端血流满意。患者症状得到缓解。支架植入后她们一直无症状。对于因SMA狭窄导致慢性肠系膜缺血的精心挑选的患者，原发性支架置入术可被视为传统手术的一种可行替代方法。
