Zhonghua wai ke za zhi [Chinese journal of surgery] · 2005
[Treatment of celiac and mesenteric arteries stenoses with interventional radiologic techniques].
Аннотация на английскомСтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод пока не подготовлен
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Wang Mao-qiang, Wang Zhi-jun, Liu Feng-yong, Wang Zhong-pu
Аннотация
OBJECTIVE: To evaluate the safety and efficacy of the interventional techniques for management of celiac and mesenteric arteries stenoses.
METHODS: Eight patients with celiac artery (CA) or superior mesenteric artery (SMA) focal stenotic lesions were treated with percutaneous transluminal balloon angioplasty (PTA) and stent placement. CA stenosis was present in 2 patients, SMA stenosis was present in 4, and both CA and SMA were involved in 2 patients. Postprandial pain was present in 4 patients, an epigastric bruit was present in 5. All patients presented with weight loss averaging 8 kg. The causes of the stenoses were atheroscleroses in 7 patients, median arcuate ligament syndrome (MALS) involvement of the CA in 1 patient.
RESULTS: PTA and stent placement was technically successful in the 8 patients. Three patients underwent stent placement in CA, 5 patients in SMA. Seven patients were treated with 1 stent, one was treated with 2 stents. The post-procedural arteriograms showed good dilation of the stenotic lesions in all patients. The puncture site hematoma occurred in 2 patients without severe consequences. Complete alleviation of abdominal pain occurred in 5 patients, significant improvement in 2, and no improvement in 1 patient. At three months after the procedures, weights were regained in 6 patients. Clinical follow-up was available in all 8 patients, with a mean follow-up of 42 months (median 28 months, range 6 to 72 months). Follow-up Doppler ultrasound examinations showed normal flow patterns, without evidences of re-stenosis in the stenting arteries. Five patients remained asymptomatic, one patient had intermittent abdominal pain even the stenting SMA to be patent. Two patients respectively died of unrelated CA/SMA stenosis in 14 and 24 months after the treatment.
CONCLUSION: PTA and stent placement are safe and effective methods for treatment of chronic CA and SMA focal stenoses, especially useful for these patients with a high surgical risk.
METHODS: Eight patients with celiac artery (CA) or superior mesenteric artery (SMA) focal stenotic lesions were treated with percutaneous transluminal balloon angioplasty (PTA) and stent placement. CA stenosis was present in 2 patients, SMA stenosis was present in 4, and both CA and SMA were involved in 2 patients. Postprandial pain was present in 4 patients, an epigastric bruit was present in 5. All patients presented with weight loss averaging 8 kg. The causes of the stenoses were atheroscleroses in 7 patients, median arcuate ligament syndrome (MALS) involvement of the CA in 1 patient.
RESULTS: PTA and stent placement was technically successful in the 8 patients. Three patients underwent stent placement in CA, 5 patients in SMA. Seven patients were treated with 1 stent, one was treated with 2 stents. The post-procedural arteriograms showed good dilation of the stenotic lesions in all patients. The puncture site hematoma occurred in 2 patients without severe consequences. Complete alleviation of abdominal pain occurred in 5 patients, significant improvement in 2, and no improvement in 1 patient. At three months after the procedures, weights were regained in 6 patients. Clinical follow-up was available in all 8 patients, with a mean follow-up of 42 months (median 28 months, range 6 to 72 months). Follow-up Doppler ultrasound examinations showed normal flow patterns, without evidences of re-stenosis in the stenting arteries. Five patients remained asymptomatic, one patient had intermittent abdominal pain even the stenting SMA to be patent. Two patients respectively died of unrelated CA/SMA stenosis in 14 and 24 months after the treatment.
CONCLUSION: PTA and stent placement are safe and effective methods for treatment of chronic CA and SMA focal stenoses, especially useful for these patients with a high surgical risk.