Perini Paolo, Baque Jean, Chau Yves, Sedat Jacques, Batt Michel
Division of Vascular Surgery, Graduate School of Medicine, University of Nice-Sophia-Antipolis, France
Division of Vascular Radiology, Graduate School of Medicine, University of Nice-Sophia-Antipolis, France.
Acta Radiol. 2014 Nov;55(9):1076-81. doi: 10.1177/0284185113511079. Epub 2013 Nov 13.
Isolated spontaneous dissection of visceral arteries, not associated with aortic dissection, is a rare condition. To date, there is no consensus on the optimal treatment strategy.
To investigate the feasibility, efficacy, and safety of percutaneous embolization for the treatment of isolated and symptomatic dissecting aneurysm of the celiac artery.
From March 2010 to October 2011, four patients were diagnosed at our institution with symptomatic dissecting aneurysm of the celiac trunk. All patients had acute abdominal pain, two had intra-abdominal hemorrhage and bleeding shock. Three patients underwent elective "trapping" embolization of the celiac trunk with Amplatzer vascular plugs in the hepatic and splenic artery and celiac trunk, and coils in left gastric artery. One patient had a splenic artery rupture and underwent selective embolization of this vessel with platinum-fiber coils.
Angiography and postoperative CT scan confirmed artery occlusion after embolization in all cases. Revascularization of celiac trunk branches was obtained via collaterals. No procedure-related adverse events occurred during follow-up (median, 4.5 months; range, 3-24 months) and vessel occlusion was maintained.
Isolated and symptomatic dissecting aneurysm of the celiac trunk can be successfully managed by embolization techniques with good short- to mid-term results.
孤立性内脏动脉自发夹层分离，不伴有主动脉夹层，是一种罕见的病症。迄今为止，对于最佳治疗策略尚无共识。
探讨经皮栓塞治疗孤立性有症状的腹腔干夹层动脉瘤的可行性、有效性和安全性。
2010年3月至2011年10月，我院诊断出4例有症状的腹腔干夹层动脉瘤患者。所有患者均有急性腹痛，2例有腹腔内出血和失血性休克。3例患者接受了选择性“套扎”栓塞术，在肝动脉、脾动脉和腹腔干使用Amplatzer血管塞，在胃左动脉使用弹簧圈。1例患者脾动脉破裂，用铂金纤维弹簧圈对该血管进行了选择性栓塞。
血管造影和术后CT扫描证实所有病例栓塞后动脉闭塞。腹腔干分支通过侧支实现了血管再通。随访期间（中位时间4.5个月；范围3 - 24个月）未发生与手术相关的不良事件，血管闭塞持续存在。
孤立性有症状的腹腔干夹层动脉瘤可通过栓塞技术成功治疗，近期至中期效果良好。
