Kunioka Shingo, Kitahara Hiroto, Yuasa Noriyuki, Fujita Miri, Otani Norifumi, Kamiya Hiroyuki
Department of Cardiovascular Surgery, Steel Memorial Muroran Hospital, Hokkaido, Japan.
Department of Cardiac Surgery, Asahikawa Medical University, Hokkaido, Japan.
Ann Vasc Surg. 2020 Apr;64:410.e11-410.e15. doi: 10.1016/j.avsg.2019.10.067. Epub 2019 Oct 31.
Inferior mesenteric artery (IMA) aneurysm is a rare occurrence, accounting for 1% of all visceral artery aneurysms and is often found incidentally. Surgical resection and endovascular intervention have been first-line treatments because IMA aneurysms have a relatively high risk of life-threatening rupture. Herein, we report the case of a 57-year-old man having a large IMA aneurysm with an arteriovenous fistula that was treated conservatively. The IMA aneurysm was incidentally found using computed tomography (CT) and was connected to the splenic vein through the abnormally dilated tortuous vessels of an arteriovenous fistula. Surgical resection was planned initially; however, preoperative follow-up CT revealed that the aneurysm had shrunk with the growth of an intraluminal thrombus. Subsequently, the condition was conservatively managed with serial CT follow-up. Two years after the first visit, the aneurysm had shrunk and been completely replaced with a thrombus.
肠系膜下动脉（IMA）动脉瘤较为罕见，占所有内脏动脉瘤的1%，且常为偶然发现。由于IMA动脉瘤有相对较高的危及生命的破裂风险，手术切除和血管内介入一直是一线治疗方法。在此，我们报告一例57岁男性患有巨大IMA动脉瘤并伴有动静脉瘘，该病例采用了保守治疗。IMA动脉瘤通过计算机断层扫描（CT）偶然发现，通过动静脉瘘异常扩张迂曲的血管与脾静脉相连。最初计划进行手术切除；然而，术前随访CT显示动脉瘤随着腔内血栓的增大而缩小。随后，通过连续CT随访对该病情进行保守处理。首次就诊两年后，动脉瘤缩小并完全被血栓替代。
