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保留幽门胰十二指肠切除术后肠系膜上动脉动静脉瘘的血管内治疗

Endovascular Treatment for a Superior Mesenteric Arteriovenous Fistula Following Pylorus Preserving Pancreatoduodenectomy.

作者信息

Kawarai Shun-Ichi, Watanabe Shuto, Aoki Chikashi, Ono Yuichi

机构信息

Division of Cardiovascular Surgery, Hachinohe City Hospital, Hachinohe, Aomori, Japan.

出版信息

Ann Vasc Dis. 2024 Dec 25;17(4):421-425. doi: 10.3400/avd.cr.24-00064. Epub 2024 Sep 25.

Abstract

A superior mesenteric arteriovenous fistula (SMAVF) following gastrointestinal surgery represents a rare vascular complication. Enhanced computed tomography with 3-dimensional reconstruction proves to be the most efficacious modality for detecting this uncommon entity. Superior mesenteric angiography becomes imperative to accurately delineate the location and extent of mesenteric vessel involvement, which is essential for devising an optimal treatment strategy. Recently, endovascular therapy has garnered significant favor due to its less invasiveness compared to surgical interventions. Herein, we present a case of SMAVF after pancreaticoduodenectomy, manifesting with symptoms indicative of portal hypertension. Successful endovascular fistula closure using a balloon-expandable stent graft was achieved.

摘要

胃肠道手术后发生的肠系膜上动静脉瘘(SMAVF)是一种罕见的血管并发症。增强计算机断层扫描三维重建被证明是检测这种罕见病症最有效的方法。肠系膜上动脉造影对于准确描绘肠系膜血管受累的位置和范围至关重要,这对于制定最佳治疗策略至关重要。最近,血管内治疗因其与手术干预相比侵入性较小而备受青睐。在此,我们报告一例胰十二指肠切除术后发生SMAVF的病例,表现出门静脉高压的症状。使用球囊可扩张支架移植物成功实现了血管内瘘口闭合。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d01f/11669029/09fea5f7e350/avd-17-421-g001.jpg

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