Abstract：
OBJECTIVE. The purpose of this study was to clarify the natural history of unruptured visceral artery aneurysms due to segmental arterial mediolysis and the efficacy of transcatheter arterial embolization. MATERIALS AND METHODS. Patients with a pathologic or clinical diagnosis of visceral artery aneurysms due to segmental arterial mediolysis between 2005 and 2015 were enrolled. For patients with clinical diagnoses, images were collected and assessed by central radiologic review. To clarify the natural history of unruptured aneurysms, the morphologic changes were assessed. The efficacy and safety of transcatheter arterial embolization for aneurysms due to segmental arterial mediolysis were evaluated. RESULTS. Forty-five patients with 123 aneurysms due to segmental arterial mediolysis were enrolled. Among the 123 aneurysms, 70 unruptured aneurysms were evaluated for natural history. Forty-five of the 70 (64%) aneurysms had no change in morphology. Among the other 25 aneurysms, nine (13% of the 70) were reduced in size, 13 (19%) disappeared, and three (4%) were newly found at follow-up. Aneurysms of the middle colic artery were ruptured in 10 of 11 (91%) cases. Transcatheter arterial embolization was performed on 45 aneurysms and was successful in all cases but caused slight arterial injury in three cases (6.7%). CONCLUSION. At initial diagnosis, unruptured aneurysms due to segmental arterial mediolysis are likely to be stable or to resolve, but the risk of rupture of aneurysms of the middle colic artery appears high. Transcatheter arterial embolization is a useful treatment, but careful manipulation is necessary.
摘要：
目标。这项研究的目的是阐明由于节段性动脉介质溶解引起的未破裂内脏动脉瘤的自然史以及经导管动脉栓塞的疗效。材料和方法。纳入了2005年至2015年之间由于节段性动脉介质溶解而病理或临床诊断为内脏动脉瘤的患者。对于有临床诊断的患者，收集图像并通过中央放射学检查进行评估.为了澄清未破裂动脉瘤的自然史，对形态学变化进行了评估.评估经导管动脉栓塞治疗节段性动脉介质溶解所致动脉瘤的疗效和安全性。结果。纳入45例患者，由于节段性动脉介质溶解导致123个动脉瘤。在123个动脉瘤中，评估了70个未破裂的动脉瘤的自然史。70例（64％）动脉瘤中有45例形态无变化。在其他25个动脉瘤中，9个(70个中的13%)尺寸缩小，13人（19%）消失，在随访中新发现了3例（4％）。11例中有10例（91％）中结肠动脉动脉瘤破裂。对45个动脉瘤进行了经导管动脉栓塞，所有病例均成功，但3例（6.7％）引起轻微的动脉损伤。结论。初步诊断时,由于节段性动脉介质溶解引起的未破裂动脉瘤可能是稳定的或消退的，但是中结肠动脉动脉瘤破裂的风险很高。经导管动脉栓塞是一种有用的医治办法，但是小心操作是必要的。
