Widman A, Speranzini M B, de Oliveira I R, Saad W A
Departamento de Radiologia (INRAD), Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, FMUSP.
Arq Gastroenterol. 1998 Jan-Mar;35(1):18-25.
The authors present the radiographical study of the aortographies of 100 consecutive patients with symptomatic atherosclerotic ischemia of the lower limbs in whom were appraised the stenosis of the celiac trunk, superior mesenteric artery, renal arteries and the presence of the inferior mesenteric artery. The parameters observed were: age, sex, solitary and concomitant stenosis. Seven patients were excluded: six because of arteritis and one because could not be analyzed. Sixty four (68.81%) of the remaining 93 patients had important stenosis (> 30%) of one or more branches of the abdominal aorta, which had a steep raise in number from the 60 decade on. There was no difference regarding to the sex of the patients. The more frequently found solitary stenosis was that of the celiac trunk (16-16.1%) followed by the renal (13-13.0%) and in the concomitant was that of the celiac trunk/renal artery (8-8.6%) and celiac trunk/superior mesenteric artery (5-5.3%). They conclude that in spite of the great number of stenosis of the branches of the abdominal aorta in this kind of patients, there was a low incidence of the concomitant stenosis of the celiac trank/superior mesenteric artery, being difficult to characterize radiologically the digestive ischemic syndrome. They point out that this highly selected group of patients, because of their basic disease, should be more extensively studied in order to identify the results of those vascular stenosis on their digestive tract and orient its eventual treatment.
作者展示了对100例连续性有症状的下肢动脉粥样硬化性缺血患者的主动脉造影的影像学研究，评估了腹腔干、肠系膜上动脉、肾动脉的狭窄情况以及肠系膜下动脉的存在情况。观察的参数有：年龄、性别、孤立性狭窄和合并狭窄。7例患者被排除：6例因动脉炎，1例因无法分析。其余93例患者中，64例（68.81%）有腹主动脉一个或多个分支的重要狭窄（>30%），从60岁起数量急剧增加。患者性别方面无差异。最常发现的孤立性狭窄是腹腔干（16 - 16.1%），其次是肾动脉（13 - 13.0%），合并狭窄中最常见的是腹腔干/肾动脉（8 - 8.6%）和腹腔干/肠系膜上动脉（5 - 5.3%）。他们得出结论，尽管这类患者中腹主动脉分支狭窄数量众多，但腹腔干/肠系膜上动脉合并狭窄的发生率较低，难以通过放射学对消化性缺血综合征进行特征描述。他们指出，由于其基础疾病，这一高度选择的患者群体应进行更广泛的研究，以确定那些血管狭窄对其消化道的影响并指导最终治疗。
