ABSTRACT
Objective To summarize the experience in the diagnosis and treatment of symptomatic splanchnic artery dissection. Methods A total of 21 patients with symptomatic splanchnic artery dissection, who were admitted to the Affiliated First Hospital of China Medical University during the period from June 2006 to March 2014, were included in this study. Combined with the literature, the clinical data, including the diagnosis and treatment, were analyzed. Results Contrast-enhanced abdominal CT and CT angiography revealed superior mesenteric artery dissection in 15 cases, celiac artery dissection in 5 cases and splenic artery dissection in one case. Conservative therapy was employed in 5 patients; among them one was complicated with hepatic artery thrombosis. Of the 16 patients who received endovascular stent placement, additional intestinal resection was performed in 2 and transcatheter thrombolysis treatment in other 2. No procedure-related severe complications occurred in perioperative period. All the patients were followed up for 2-74 months (mean of 19.1 months). In patients who received endovascular stent placement, the abdominal pain and the bloody stool were relieved or disappeared, and no abdominal pain recurred. CT angiography showed that in-stent blood flow was fluent, the stent was in good position, and neither stenosis nor thrombosis was observed. One patient with superior mesenteric artery dissection died of stroke three months after the treatment. Conclusion It is very important to make early diagnosis and to adopt early treatment for symptomatic splanchnic artery dissection. CT angiography can confirm the diagnosis in most cases, but attention should be paid to some atypical manifestations. For the treatment of splanchnic artery dissection, endovascular stent placement is mini-invasive, safe and reliable.
ABSTRACT
Objective To evaluate the clinical outcome of stent placement in the superior vena cava (SVC) syndrome. Methods Twelve patients with stenosis of the superior vena cava and/or its main tributaries underwent placement of a self-expanding endovascular Wallstents (11 men,1 woman,mean age 51 years). Results Until death or completion of the study,the SVC syndrome was successfully controlled in 92% of the cases (11/12). There were no early procedure-related complications such as early occlusion,or migration of the stent. The recurrence rate was 16.7%. Conclusion Percutaneous venous stent placement in the superior vena cava is a relatively safe and simple procedure. In majority of cases,the symptoms of the SVC syndrome are relieved immediately and completely. Complications are rare.