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COVID-19肺炎后急性肠系膜上动脉闭塞的血管内介入治疗:两例报告

Endovascular Intervention for Acute Superior Mesenteric Artery Occlusion Following COVID-19 Pneumonia: Two Case Reports.

作者信息

Le Duy Cao Phuong, Bui Hoa The, Vo Quan Duy

机构信息

Faculty of Medicine, Nguyen Tat Thanh University Ho Chi Minh City Vietnam.

Department of Cardiovascular Intervention, Nguyen Tri Phuong Hospital Ho Chi Minh City, Vietnam.

出版信息

Interv Cardiol. 2024 Sep 11;19:e17. doi: 10.15420/icr.2024.09. eCollection 2024.

Abstract

COVID-19 patients may experience acute mesenteric ischaemia. Identifying acute mesenteric ischaemia is challenging, particularly as initial symptoms are often vague and easily overlooked. Early detection and immediate intervention to restore blood flow can prevent these severe consequences. Presented in this report are two cases of superior mesenteric artery (SMA) thrombosis following severe acute respiratory syndrome coronavirus 2 infection. CT scans demonstrated SMA thrombosis in both patients, with no evidence of bowel necrosis. Endovascular intervention with self-expanding stent placement was performed after angiographic confirmation of the diagnosis. At 6-month follow-up, both patients remained asymptomatic on dual antiplatelet therapy. Atypical gastrointestinal manifestations in COVID-19 patients should raise suspicion for uncommon complications, such as SMA thrombosis. For SMA occlusion without associated bowel necrosis, endovascular therapy represents a viable treatment approach.

摘要

新冠肺炎患者可能会出现急性肠系膜缺血。识别急性肠系膜缺血具有挑战性,尤其是因为初始症状往往模糊且容易被忽视。早期检测并立即进行恢复血流的干预措施可预防这些严重后果。本报告介绍了两例严重急性呼吸综合征冠状病毒2感染后发生的肠系膜上动脉(SMA)血栓形成病例。CT扫描显示两名患者均有SMA血栓形成,无肠坏死迹象。在血管造影确诊后进行了置入自膨式支架的血管内介入治疗。在6个月的随访中,两名接受双联抗血小板治疗的患者均无症状。新冠肺炎患者的非典型胃肠道表现应引起对诸如SMA血栓形成等罕见并发症的怀疑。对于无相关肠坏死的SMA闭塞,血管内治疗是一种可行的治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2708/11413984/c6f0ca5d9aec/icr-19-e17-g001.jpg

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