Department of Vascular Surgery, 72562Mater Hospital, South Brisbane, Queensland, Australia.
Department of General Surgery, Mater Hospital, South Brisbane, Queensland, Australia.
Vasc Endovascular Surg. 2022 Feb;56(2):216-219. doi: 10.1177/15385744211054267. Epub 2021 Nov 8.
Fibromuscular dysplasia is a non-inflammatory, non-atherosclerotic vascular disease that commonly affects renal and carotid arteries but involvement of virtually any vascular territory has been observed. This is a case report of a ruptured left gastric artery aneurysm as the first presentation of fibromuscular dysplasia. After written consent from the patient, relevant clinical notes and imaging were retrospectively reviewed and critically analysed. This case reiterates the importance of considering fibromuscular dysplasia as an uncommon cause of visceral artery aneurysms. In addition, this case shows that the impact of visceral artery vasospasm on endovascular access should not be underestimated and subsequent attempts can be successful after a period of resuscitation. After initial difficulty in endovascular treatment due to visceral vasospasm, the case was successfully managed with with staged open ligation and endovascular embolization after a period of resuscitation. FMD is an important differential diagnosis to consider in cases of visceral aneurysms.
纤维肌性发育不良是一种非炎症性、非动脉粥样硬化性血管疾病,常累及肾动脉和颈动脉,但实际上任何血管区域都可能受累。这是一例胃左动脉破裂性动脉瘤作为纤维肌性发育不良首发表现的病例报告。征得患者书面同意后,回顾性查阅并批判性分析了相关临床记录和影像学资料。本病例再次强调了将纤维肌性发育不良视为内脏动脉动脉瘤不常见病因的重要性。此外,本病例表明,内脏动脉血管痉挛对腔内入路的影响不应被低估,经过一段时间的复苏后,后续尝试可能会成功。在最初由于内脏血管痉挛导致腔内治疗困难后,经过一段时间的复苏,该病例成功地采用分期开放结扎和腔内栓塞进行治疗。在考虑内脏动脉瘤时,纤维肌性发育不良是一个重要的鉴别诊断。