使用球囊扩张式覆膜支架治疗肠系膜上动脉门静脉瘘。

Treatment of superior mesenteric artery portal vein fistula with balloon-expandable stent graft.

作者信息

Chiriano J, Teruya T H, Zhang W W, Abou-Zamzam A M, Bianchi C

机构信息

Department of Surgery, Loma Linda University, Loma Linda, CA.

出版信息

Ann Vasc Surg. 2009 Jan-Feb;23(1):99-102. doi: 10.1016/j.avsg.2008.10.001.

DOI:10.1016/j.avsg.2008.10.001

PMID:19135911

Abstract

Visceral artery to portal vein arteriovenous fistulas are rare and difficult to treat. Covered stents have made treatment of pseudoaneurysms and arteriovenous fistulas feasible utilizing minimally invasive techniques. We present a case of a 46-year-old male with a remote history of an exploratory laparotomy after a motorcycle accident who presented with abdominal pain, malaise, and jaundice. A computed tomographic scan revealed a superior mesenteric artery to portal vein arteriovenous fistula. A large arteriovenous fistula was confirmed by arteriography. A balloon-expandable stent graft was placed across the arteriovenous fistula in the superior mesenteric artery. Postprocedure, the patient's abdominal pain resolved and his bilirubin decreased from 2.9 to 0.4. Endovascular repair of a superior mesenteric to portal arteriovenous fistula utilizing a stent graft is feasible and minimally invasive.

摘要

内脏动脉至门静脉动静脉瘘罕见且治疗困难。覆膜支架使利用微创技术治疗假性动脉瘤和动静脉瘘成为可能。我们报告一例46岁男性，有摩托车事故后剖腹探查术史，现出现腹痛、不适和黄疸。计算机断层扫描显示肠系膜上动脉至门静脉动静脉瘘。动脉造影证实存在一个大的动静脉瘘。在肠系膜上动脉的动静脉瘘处放置了一个球囊可扩张支架移植物。术后，患者腹痛缓解，胆红素从2.9降至0.4。利用支架移植物对肠系膜上动脉至门静脉动静脉瘘进行血管内修复是可行的且微创。