Newcomer Jack B, Chishti Emad A, Raissi Driss
University of Kentucky College of Medicine, Lexington, Kentucky, United States.
Division of Vascular and Interventional Radiology, Department of Radiology, University of Kentucky, Lexington, Kentucky, United States.
J Clin Imaging Sci. 2022 Feb 24;12:9. doi: 10.25259/JCIS_226_2021. eCollection 2022.
HIV is a multisystem disease process that can affect the cardiovascular system resulting in vasculopathy. As highly active anti-retroviral therapy has allowed patients to live longer with the disease, vascular complications such as aneurysms, occlusive disease, spontaneous arteriovenous fistulae, and arterial dissections have been described. The pathogenesis of vascular-related complications in HIV is poorly understood but is thought to involve an interplay between viral-induced inflammation, vascular smooth muscle changes, endothelial alterations, and circulating blood factors. The most well-described management strategies for symptomatic aneurysm-related complications are surgical in nature, with mostly anecdotal reports of endovascular intervention. We present a case of a 24-year-old male who was found to have findings consistent with HIV vasculopathy on angiography after presenting with acute GI hemorrhage secondary to left gastric artery bleeding. Our patient was managed with endovascular embolization. Although studies have shown promise regarding the endovascular management of HIV-related aneurysmal complications in the short term, more research is needed to evaluate the long-term success of these interventions.
人类免疫缺陷病毒（HIV）是一种多系统疾病进程，可影响心血管系统，导致血管病变。随着高效抗逆转录病毒疗法使患者能够携带该疾病存活更长时间，诸如动脉瘤、闭塞性疾病、自发性动静脉瘘和动脉夹层等血管并发症已被描述。HIV相关血管并发症的发病机制尚不清楚，但被认为涉及病毒诱导的炎症、血管平滑肌变化、内皮改变和循环血液因子之间的相互作用。对于有症状的动脉瘤相关并发症，最常描述的管理策略本质上是手术治疗，关于血管内介入的报道大多是轶事性的。我们报告一例24岁男性病例，该患者因胃左动脉出血继发急性胃肠道出血就诊，血管造影显示其表现与HIV血管病变一致。我们的患者接受了血管内栓塞治疗。尽管研究表明血管内治疗HIV相关动脉瘤并发症在短期内有前景，但需要更多研究来评估这些干预措施的长期成功率。
