选择性内脏血管造影在腹腔干肠系膜干内脏动脉瘤手术策略规划中的应用。
Use of selective visceral angiography in surgical strategy planning for celiac artery aneurysm in the celiacomesenteric trunk.
机构信息
Department of Cardiovascular Surgery, Toyonaka Municipal Hospital, 4-14-1, Shibahara, Toyonaka, Osaka, 560-8565, Japan.
Department of Cardiovascular Surgery, Nippon Life Hospital, Osaka, Japan.
出版信息
J Cardiothorac Surg. 2024 Jan 19;19(1):11. doi: 10.1186/s13019-024-02483-7.
BACKGROUND
The celiacomesenteric trunk (CMT) is a common duct of the celiac artery (CA) and the superior mesenteric artery originating from the aorta, which is an uncommon anatomical variant of visceral artery circulation. Because of the variety of visceral circulation in those with CMT, the visceral circulation associated with each branch should be evaluated prior to surgical treatment of visceral artery aneurysm in the CMT.
CASE PRESENTATION
A 64-year-old woman was diagnosed with a CA aneurysm in the CMT. Aneurysmectomy of the aneurysm was performed successfully. On preoperative selective visceral angiography, the CA was seen to bifurcate into the common hepatic and splenic artery. The left gastric artery was directly isolated from the aorta and perfused to the common hepatic and splenic artery through collateral circulation. These findings showed that celiac artery embolization is anatomically feasible, even in cases of celiac artery aneurysm rupture.
CONCLUSIONS
Selective visceral angiography can contribute to surgical strategy planning for CA aneurysm with CMT.
背景
腹腔肠系膜干（CMT）是源自主动脉的腹腔动脉（CA）和肠系膜上动脉的共同通道，是内脏动脉循环中一种不常见的解剖变异。由于 CMT 患者的内脏循环多种多样，在对 CMT 中的内脏动脉动脉瘤进行手术治疗之前，应评估与每个分支相关的内脏循环。
病例介绍
一名 64 岁女性被诊断为 CMT 中的 CA 动脉瘤。成功地进行了动脉瘤切除术。在术前选择性内脏血管造影中，可见 CA 分为肝总动脉和脾动脉。胃左动脉直接从主动脉分离出来，并通过侧支循环向肝总动脉和脾动脉供血。这些发现表明，即使在 CA 动脉瘤破裂的情况下，腹腔动脉栓塞在解剖上也是可行的。
结论
选择性内脏血管造影有助于制定 CMT 合并 CA 动脉瘤的手术策略。
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