Department of Vascular Surgery, The Second Xiangya Hospital of Central South University, Changsha, China.
Vascular Disease Institute of Central South University, Changsha, China.
Vascular. 2021 Aug;29(4):516-526. doi: 10.1177/1708538120962884. Epub 2020 Oct 29.
To characterize the clinical features, treatment, and prognosis of superior mesenteric artery aneurysms and provide evidence for clinical decision-making.
We retrospectively reviewed the diagnosis and treatment of 18 cases of superior mesenteric artery aneurysm admitted to our center from 2003 to 2020, including demographic data, risk factors, clinical manifestations, diagnosis, treatment strategies, and follow-up results.
The average age of the patients was 49.1 years, and males accounted 83.3%. The development of the disease was associated with infection, hypertension, pancreatitis, and trauma, but no significant associations with atherosclerosis were noted by our results. Nine patients were diagnosed with true aneurysm, seven patients with pseudoaneurysm, and two patients with dissecting aneurysm. Rupture of aneurysm occurred in three patients (16.7%), and one of them died before surgery. The surgery success rate was 94.1%, and open surgery was performed on nine patients, endovascular surgery on three patients, and conservative treatment on three patients. The follow-up rate was 77.8% (14/18), and the average follow-up time was 48.2 months. The mortality and reintervention rate during follow-up was 0. The two-year patency rate of artificial vessels and covered stents was 50%.
The clinical manifestations and features of superior mesenteric artery aneurysms vary between patients. Careful evaluation of vascular anatomy and personalized treatment strategy are critical in the management of superior mesenteric artery aneurysms. Midterm follow-up results of superior mesenteric artery aneurysms are satisfactory.
描述肠系膜上动脉动脉瘤的临床特征、治疗方法和预后，为临床决策提供依据。
我们回顾性分析了 2003 年至 2020 年期间我院收治的 18 例肠系膜上动脉动脉瘤患者的诊断和治疗情况，包括人口统计学数据、危险因素、临床表现、诊断、治疗策略和随访结果。
患者平均年龄为 49.1 岁，男性占 83.3%。疾病的发展与感染、高血压、胰腺炎和外伤有关，但与动脉粥样硬化无明显相关性。9 例患者被诊断为真性动脉瘤，7 例为假性动脉瘤，2 例为夹层动脉瘤。3 例（16.7%）患者发生动脉瘤破裂，其中 1 例在手术前死亡。手术成功率为 94.1%，9 例患者行开放手术，3 例患者行血管内手术，3 例患者行保守治疗。随访率为 77.8%（14/18），平均随访时间为 48.2 个月。随访期间死亡率和再干预率为 0，人造血管和覆膜支架的两年通畅率为 50%。
肠系膜上动脉动脉瘤患者的临床表现和特征各不相同。仔细评估血管解剖结构和制定个性化治疗策略对于肠系膜上动脉动脉瘤的治疗至关重要。肠系膜上动脉动脉瘤的中期随访结果令人满意。
