Nursing Teaching and Research, Changzhou No. 2 People's Hospital, Changzhou, China; Department of Interventional and Vascular Surgery, Changzhou No. 2 People's Hospital, Changzhou, China.
Department of Interventional Radiology, Third Affiliated Hospital of Soochow University, Changzhou, China.
J Vasc Interv Radiol. 2019 Dec;30(12):1964-1971. doi: 10.1016/j.jvir.2019.05.005. Epub 2019 Sep 18.
To retrospectively investigate factors associated with mesenteric artery remodeling after conservative management of isolated mesenteric artery dissection (IMAD) (dissection of the mesenteric arteries in the absence of aortic dissection or other known causes).
A total of 107 patients diagnosed with IMAD between February 2010 and October 2018 were identified. Eighteen patients were excluded because they underwent stent placement (n = 11) or were lost to follow-up (n = 7). A total of 89 patients who underwent conservative management were therefore included in the study. Cox regression analysis was performed to identify factors associated with mesenteric artery remodeling.
During 15.9 ± 10.9 months of follow-up, complete remodeling of the mesenteric artery was achieved in 66 patients (74.2%), and partial remodeling was achieved in 23 patients (25.8%). Of the 66 patients with complete remodeling, 6 (9.1%) had type IIa IMAD (visible false lumen, no visible re-entry site), and 60 (90.9%) had type IIb IMAD (thrombosed false lumen). The mean interval between IMAD diagnosis and complete remodeling was 14.4 ± 5.4 months for all patients. The mean intervals for patients with type IIa IMAD were 20.0 ± 6.2 months and 13.9 ± 5.1 months for patients with type IIb IMAD (P = .015). Mesenteric artery remodeling was significantly associated with the presence of symptoms (odds ratio, 10.800; 95% confidence interval, 1.961-59.470; P = .006).
Complete remodeling of the mesenteric artery in patients with IMAD treated with conservative management is common, and the presence of symptoms is associated with complete remodeling.
回顾性分析孤立性肠系膜动脉夹层（IMAD）（肠系膜动脉夹层而无主动脉夹层或其他已知原因）保守治疗后肠系膜动脉重构的相关因素。
共纳入 2010 年 2 月至 2018 年 10 月期间诊断为 IMAD 的 107 例患者。18 例患者因支架置入（n=11）或失访（n=7）而被排除在外。因此，共有 89 例接受保守治疗的患者纳入本研究。采用 Cox 回归分析识别与肠系膜动脉重构相关的因素。
在 15.9±10.9 个月的随访期间，66 例（74.2%）患者肠系膜动脉完全重构，23 例（25.8%）患者部分重构。在完全重构的 66 例患者中，6 例（9.1%）为 IIa 型 IMAD（可见假腔，无可见再入口），60 例（90.9%）为 IIb 型 IMAD（血栓形成的假腔）。所有患者肠系膜动脉完全重构的平均时间间隔为 14.4±5.4 个月。IIa 型 IMAD 患者的平均时间间隔为 20.0±6.2 个月，IIb 型 IMAD 患者为 13.9±5.1 个月（P=0.015）。肠系膜动脉重构与症状的存在显著相关（优势比，10.800；95%置信区间，1.961-59.470；P=0.006）。
接受保守治疗的 IMAD 患者肠系膜动脉完全重构较为常见，且症状的存在与完全重构相关。
