Yamaguchi Hidenori, Murata Satoru, Ueda Tatsuo, Mine Takahiko, Onozawa Shiro, Hayashi Hiromitsu, Kumita Shin-Ichiro
Department of Radiology, Nippon Medical School, Tamanagayama Hospital, 1-7-1, Nagayama, Tama-shi, Tokyo, 206-8512, Japan.
Center for Interventional Radiology, Teikyo University Chiba Medical Center, 426-3 Anesaki, Ichihara-City, Chiba, 299-0011, Japan.
CVIR Endovasc. 2021 Apr 7;4(1):35. doi: 10.1186/s42155-021-00225-7.
Spontaneous isolated visceral artery dissection is rarely encountered. Endovascular intervention with good outcomes has become popular for patients with persistent symptoms or developing ischemia. We could perform life-saving treatment for a spontaneous isolated superior mesenteric artery dissection with a unique endovascular intervention.
We describe the case of an 80-year-old man who presented with acute abdominal pain and a spontaneous isolated superior mesenteric artery dissection measuring 35 mm in major diameter and 6.6 mm in minor diameter on abdominal contrast-enhanced computed tomography. After admission, abdominal pain was progressive, and a repeated scan revealed progression of the dissection. As an endovascular intervention, via the bilateral femoral approach, detachable coils were placed in the false lumen of the superior mesenteric artery dissection through the false lumen under the micro-balloon occlusion at the point of re-entry and entry through the true lumen to prevent coil migration. Technical and clinical success was achieved without serious adverse events.
Coil embolization using micro-balloon assistance combined with the double-catheter technique for a large entry and re-entry false lumen of a spontaneous isolated superior mesenteric artery dissection was useful and feasible.
自发性孤立性内脏动脉夹层很少见。对于有持续症状或发生缺血的患者，具有良好预后的血管内介入治疗已变得很普遍。我们可以通过一种独特的血管内介入治疗对自发性孤立性肠系膜上动脉夹层进行挽救生命的治疗。
我们描述了一名80岁男性患者的病例，该患者因急性腹痛就诊，腹部增强计算机断层扫描显示自发性孤立性肠系膜上动脉夹层，大直径为35毫米，小直径为6.6毫米。入院后，腹痛进行性加重，重复扫描显示夹层进展。作为血管内介入治疗，通过双侧股动脉入路，在微球囊闭塞再入口处并经真腔进入的情况下，将可脱卸弹簧圈通过假腔置入肠系膜上动脉夹层的假腔内，以防止弹簧圈移位。获得了技术和临床成功，且无严重不良事件。
对于自发性孤立性肠系膜上动脉夹层的大入口和再入口假腔，使用微球囊辅助结合双导管技术进行弹簧圈栓塞是有用且可行的。
