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经血管内再次治疗由胃左动脉分支供血的脾动脉瘤:一例报告

Endovascular retreatment of a splenic artery aneurysm refilled by collateral branches of the left gastric artery: a case report.

作者信息

Ierardi Anna Maria, Petrillo Mario, Bacuzzi Alessandro, Floridi Chiara, Dionigi Gianlorenzo, Piffaretti Gabriele, Carrafiello Gianpaolo

机构信息

Department of Radiology, University of Insubria, Ospedale di Circolo e Fondazione Macchi, Viale Borri 57, 21100 Varese, VA, Italy.

出版信息

J Med Case Rep. 2014 Dec 17;8:436. doi: 10.1186/1752-1947-8-436.

Abstract

INTRODUCTION

A rare case of a splenic artery aneurysm refilled by a hypertrophic branch originating from the left gastric artery retreated with an endovascular approach is reported. To the best of our knowledge, this is the first such case reported in the literature.

CASE PRESENTATION

A hilum splenic artery aneurysm of a 43-year-old Caucasian woman was treated with endovascular ligature. Contrast-enhanced computed tomography performed after 1 month revealed reperfusion of the aneurysm and a new angiogram demonstrated a hypertrophic vessel from her left gastric artery supplying the sac of the aneurysm. It was catheterized by splenic hilum branches and it was embolized with coil and glue. Contrast-enhanced computed tomography performed after 3 months confirmed complete exclusion of the sac of the aneurysm.

CONCLUSIONS

Our patient represents the first rare case of a splenic artery aneurysm refilled from a branch of her left gastric artery not visible at first at angiography or at contrast-enhanced computed tomography performed after 1 month; it was revealed at the second angiography and it was definitively embolized. These eventualities and possibilities of treatment, although rare, should be kept in mind for each patient with similar presentation.

摘要

引言

报道了一例罕见的脾动脉瘤,其由发自胃左动脉的增粗分支再通,采用血管内治疗方法治愈。据我们所知,这是文献中首次报道的此类病例。

病例介绍

一名43岁白种女性的脾门部脾动脉瘤采用血管内结扎治疗。1个月后进行的增强计算机断层扫描显示动脉瘤再灌注,新的血管造影显示来自其胃左动脉的一条增粗血管为动脉瘤囊供血。通过脾门分支对其进行插管,并使用弹簧圈和胶水进行栓塞。3个月后进行的增强计算机断层扫描证实动脉瘤囊完全闭塞。

结论

我们的患者代表了首例罕见的脾动脉瘤病例,其最初在血管造影或1个月后进行的增强计算机断层扫描中未发现由胃左动脉分支再通;在第二次血管造影时发现并最终进行了栓塞。对于每例有类似表现的患者,尽管这些情况和治疗可能性很少见,但仍应牢记。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ea38/4301936/29eda743e58c/13256_2014_3035_Fig1_HTML.jpg

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