Uotani Kensuke, Yamaguchi Masato, Okada Takuya, Gentsu Tomoyuki, Sakamoto Noriaki, Kawasaki Ryota, Taniguchi Takanori, Tomimatsu Hirotaka, Sugimoto Koji, Murakami Takamichi
Department of Radiology, Hyogo Prefectural Awaji Medical Center, Japan.
Department of Diagnostic and Interventional Radiology, Kobe University Graduate School of Medicine, Japan.
Interv Radiol (Higashimatsuyama). 2024 May 14;9(2):55-61. doi: 10.22575/interventionalradiology.2022-0045. eCollection 2024 Jul 1.
To investigate the midterm stent patency and patient prognosis after stenting for superior mesenteric artery malperfusion complicating with acute aortic dissection.
Thirteen patients who underwent branch vessel stenting for superior mesenteric artery malperfusion between 2011 and 2021 in six institutions were retrospectively reviewed. By comparing pre- and postoperative computed tomography scans in the same plane, the length of the stent implanted in the superior mesenteric artery and the stent-to-vessel diameter ratio were measured. The technical and clinical success of stenting, midterm patient prognosis, and stent patency were evaluated.
Superior mesenteric artery stenting was technically successful in 12 patients (92.3%). The mean length of the stents implanted in the superior mesenteric artery was 61.3 ± 39.4 mm (range, 14-127 mm). The mean proximal and distal stent-to-vessel diameter ratios were 1.02 ± 0.16 and 1.30 ± 0.42, respectively. A weak correlation was found between the length of the stents implanted in the superior mesenteric artery and the distal stent-to-vessel diameter ratio (R = 0.34). Two major complications occurred, one of which resulted in death within 30 days, and 12 (92.3%) were clinically successful. Of these 12 patients, no recurrent intestinal ischemia occurred during the follow-up duration (mean, 45.2 months). Partial occlusion of the stent distal edge without intestinal ischemia was observed in one patient (distal stent-to-vessel diameter ratio = 2.33) 42 months after stenting. The overall survival rate and primary stent patency rate were 84.6% and 91.7%, respectively.
Midterm stent patency and survival after superior mesenteric artery stenting for malperfusion were acceptable.
探讨肠系膜上动脉灌注不良合并急性主动脉夹层支架置入术后的中期支架通畅情况及患者预后。
回顾性分析2011年至2021年在6家机构接受肠系膜上动脉灌注不良分支血管支架置入术的13例患者。通过比较同一平面术前和术后的计算机断层扫描，测量肠系膜上动脉植入支架的长度及支架与血管直径比。评估支架置入的技术和临床成功率、中期患者预后及支架通畅情况。
12例患者（92.3%）的肠系膜上动脉支架置入技术成功。肠系膜上动脉植入支架的平均长度为61.3±39.4mm（范围14 - 127mm）。支架近端和远端与血管直径比的平均值分别为1.02±0.16和1.30±0.42。发现肠系膜上动脉植入支架的长度与远端支架与血管直径比之间存在弱相关性（R = 0.34）。发生2例主要并发症，其中1例在30天内死亡，12例（92.3%）临床成功。在这12例患者中，随访期间（平均45.2个月）未发生复发性肠缺血。1例患者（远端支架与血管直径比 = 2.33）在支架置入42个月后观察到支架远端边缘部分闭塞但无肠缺血。总体生存率和支架初始通畅率分别为84.6%和91.7%。
肠系膜上动脉灌注不良支架置入术后的中期支架通畅情况及生存率尚可接受。
