目的:我们比较了保守治疗的早期和中期(31,3-63个月)结果,裸支架治疗(BST)和裸支架辅助卷绕治疗(BSACT),以确定对有症状的孤立性肠系膜上动脉夹层(SISMAD)患者最有效的治疗方法。
方法:本回顾性研究包括2016年1月至2021年12月间连续入住研究医院的SISMAD患者。他们的人口统计数据,临床发现,治疗方案,分析早期结局和随访结果.
结果:共121例患者纳入研究(23例保守治疗,42与BST,56与BSACT)。91.3%的保守患者症状缓解,而所有BST或BSACT患者(100%)症状缓解,p=.035。两种血管内治疗(EVT)的住院时间没有显着差异(p=0.9051),但与保守治疗相比,住院时间显著缩短(p<0.0001).BSACT与BSACT的完全重塑的累积率为100%。BST的46.3%(p<.0001)与保守患者为42.9%(p<0.0001)。最后两组之间没有显着差异(p=0.3925)。随访时,BSACT组腹痛复发和动脉瘤形成的不良事件发生率也显著较低。
结论:BSACT治疗SISMAD有较好的早期结局。中期随访时,累积完全重塑率和无事件生存率令人满意。BSACT是SISMAD的有效方法。
BACKGROUND: We compared the early and midterm (31, 3-63 months) outcomes of conservative treatment, bare stent treatment (BST), and bare stent-assisted coiling treatment (BSACT) to determine the most effective treatment for patients with symptomatic isolated superior mesenteric artery dissection (SISMAD).
METHODS: Consecutive patients with SISMAD admitted to the study hospital between January 2016 and December 2021 were included in this retrospective study. Their demographic data, clinical findings, treatment options, early outcomes, and follow-up results were analyzed.
RESULTS: A total of 121 patients were included in the study (23 with conservative treatment, 42 with BST, and 56 with BSACT). Symptoms were relieved in 91.3% of conservative patients, whereas all patients (100%) with BST or BSACT had symptom relief (P = 0.035). There was no significant difference in the length of hospital stay between the 2 endovascular treatments (P = 0.9051), but hospital stay was significantly shorter compared to conservative treatment (P < 0.0001). The cumulative rate of complete remodeling was 100% for BSACT versus 46.3% for BST (P < 0.0001) versus 42.9% for conservative patients (P < 0.0001). There were no significant differences between the last 2 groups (P = 0.3925). The prevalence of adverse events for abdominal pain recurrence and aneurysm formation was also significantly lower in the BSACT group at follow-up.
CONCLUSIONS: BSACT for SISMAD has a preferable early outcome. The cumulative complete remodeling rate and the event-free survival rate are satisfactory at midterm follow-up. BSACT is an effective approach for SISMAD.