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经血管内介入治疗自发性腹腔干夹层的病例报告。

A case report of Spontaneous celiac artery dissection treated by endovascular intervention.

作者信息

Liu Jinbo, Zhao Na, Zhao Hongwei, Li Tianrun, Wang Hongyu

机构信息

Department of Vascular Medicine; Peking University Shougang Hospital, Beijing 100144, China.

Department of Interventional vascular surgery; Peking University Third Hospital, Beijing 100191, China.

出版信息

Radiol Case Rep. 2024 Aug 14;19(11):4880-4885. doi: 10.1016/j.radcr.2024.07.154. eCollection 2024 Nov.

Abstract

Spontaneous celiac artery dissection is uncommon. Abdominal pain is a common clinical presentation. Conservative medical treatments, endovascular interventions, and open surgery are used to treat spontaneous celiac artery dissection. A 49-year-old male patient visited our hospital, with back and subxiphoid pain that had persisted for 11 hours. He has been smoking 40 cigarettes a day for 20 years. The blood pressure was 180/100mmHg. Aortic computed tomography angiography (CTA) images revealed dissection of the celiac artery, common hepatic artery, left hepatic artery, right hepatic artery, and splenic artery. Urapidil hydrochloride and isosorbide dinitrate were administered to lower the blood pressure to approximately 110/70 mmHg. However, the back and subxiphoid pain persisted without relief. Angiography was performed and a vascular stent (BARD, LIFE STENT, VASCULAR, 8 × 60) was implanted into the celiac artery without involving the branches. Pain was immediately relieved after interventional therapy. The patient was discharged after 4 days. A subsequent aortic CTA after 10 months confirmed that the celiac artery dissection had still not reoccurred.

摘要

自发性腹腔干动脉夹层并不常见。腹痛是其常见的临床表现。保守药物治疗、血管内介入治疗和开放手术可用于治疗自发性腹腔干动脉夹层。一名49岁男性患者因背部及剑突下疼痛持续11小时前来我院就诊。他有20年每天吸烟40支的习惯。血压为180/100mmHg。主动脉计算机断层扫描血管造影(CTA)图像显示腹腔干动脉、肝总动脉、肝左动脉、肝右动脉和脾动脉夹层。给予盐酸乌拉地尔和硝酸异山梨酯将血压降至约110/70mmHg。然而,背部及剑突下疼痛持续未缓解。进行了血管造影,并在腹腔干动脉未累及分支的情况下植入了一枚血管支架(巴德公司,生命支架,血管,8×60)。介入治疗后疼痛立即缓解。患者4天后出院。10个月后的后续主动脉CTA证实腹腔干动脉夹层仍未复发。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4f6e/11372718/a57a1e12cff8/gr1.jpg

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