脈管学55巻11号　pp

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1 Online publication December 10, 原著要旨 : SMA short segment J Jpn Coll Angiol 2015; 55: Key words: superior mesenteric artery, dissection, conservative treatment, thrombosed false lumen, occluded true lumen はじめに SMA CT SMA SMA 21 対象と方法 SMA 21 retrospective 1. 患者背景 doi: /jca Marfan Table 1 2. 自覚症状と診断法 follow SMA kg CT 3. 解離の性状 SMA 9 43 SMA cm cm THE JOURNAL of JAPANESE COLLEGE of ANGIOLOGY Vol. 55

2 治療と Follow up Table 1 Patient characteristics Age (years) 52 (39 67) Sex (male) 18 (85%) Hypertension 13 (62%) Smoker 13 (62%) Dyslipidemia 4 (19%) Celebrovascular disease 3 (14%) Type 2 diabetes mellitus 0 (0%) Ischemic heart disease 0 (0%) Connective tissue disease 0 (0%) SMA follow follow follow CT SMA / CT follow open surgery SMA 21 1 SMA 2 cm φ6 mm Fig. 1A, B 1 CPK LDH follow mm 18 mm SMA 結果症例提示 SMA 13.6 cm 4.3 cm 脈管学 Vol. 55

A B 4 15 CT 2 51 SMA 1.8 cm 18 cm 2.3 cm 1 cm Fig. 2A CT 5 CT Fig.

3 193 Figure 1 A: This patient was referred to us because of abdominal angina at four months after the onset of SMA dissection. Angiogram showed occlusion of SMA (arrow). B: Endovascular balloon angioplasty was employed to the patient. A B 4 15 CT 2 51 SMA 1.8 cm 18 cm 2.3 cm 1 cm Fig. 2A CT 5 CT Fig. 2B SMA 10 cm 3 cm 1 cm CT 5 17 考察 SMA CT 1~3 50 SMA 1 2 cm 4 ULP entry SMA 1, 2 5, SMA short segment 3 1 THE JOURNAL of JAPANESE COLLEGE of ANGIOLOGY Vol. 55

B: This CT was taken at 5 hours after the initial CT (Figure 2A) and showed spontaneous recanalization

4 194 Figure 2 A: CT angiogram which was taken at other hospital showed acute occlusion (arrow heads) of true lumen of the SMA because of thrombosed false lumen. B: This CT was taken at 5 hours after the initial CT (Figure 2A) and showed spontaneous recanalization (arrow) of the occluded true lumen. A B 1 1 SMA SMA 1 SMA cm ~ SMA short segment cm 14, 15 TAE + 16, 17 SMA 6 脈管学 Vol. 55

5 結語 SMA 21 1 SMA 利益相反文献 ; 22: ; 71: ; 43: Solis MM, Ranval TJ, McFarland DR, et al: Surgical treatment of superior mesenteric artery dissecting aneurysm and simultaneous celiac artery compression. Ann Vasc Surg 1993; 7: ; 45: ; 21: , 33: ; 45: Froment P, Alerci M, Vandoni RE, et al: Stenting of a spontaneous dissection of the superior mesenteric artery: a new therapeutic approach? Cardiovasc Intervent Radiol 2004; 27: Morris JT, Guerriero J, Sage JG, et al: Three isolated superior mesenteric artery dissections: update of previous case reports, diagnostics, and treatment options. J Vasc Surg 2008; 47: Lim EH, Jung SW, Lee SH, et al: Endovascular management for isolated spontaneous dissection of the superior mesenteric artery: report of two cases and literature review. J Vasc Interv Radiol 2011; 22: Li N, Lu QS, Zhou J, et al: Endovascular stent placement for treatment of spontaneous isolated dissection of the superior mesenteric artery. Ann Vasc Surg 2014; 28: Rong JJ, Qian AM, Sang HF, et al: Immediate and middle term outcome of symptomatic spontaneous isolated dissection of the superior mesenteric artery. Abdom Imaging 2015; 40: ; 6: ; 45: Satokawa H, Seto Y, Yamamoto A, et al: A case report of aneuysmectomy after thrombo-intimectomy for spontaneous isolated superior mesenteric artery dissection. Ann Vasc Dis 2012; 5: ; 27: ; 21: THE JOURNAL of JAPANESE COLLEGE of ANGIOLOGY Vol. 55

6 196 Efficacy of the Conservative Treatment for Isolated Dissection of the Superior Mesenteric Artery Takayuki Saito, 1 Taichi Tsuji, 2 Mika Goto, 2 Yukihide Numata, 1 Yoshizumi Asano, 2 Masahiro Kajiguchi, 2 Mitsunori Harada, 2 Shinji Mokuno, 2 and Yuji Yamanaka 1 1Department of Cardiovascular Surgery, Kariya Toyota General Hospital, Aichi, Japan 2 Department of Cardiology, Kariya Toyota General Hospital, Aichi, Japan Key words: superior mesenteric artery, dissection, conservative treatment, thrombosed false lumen, occluded true lumen We report herein a retrospective study which included 21 consecutive patients who were diagnosed with isolated superior mesenteric artery (SMA) dissection at our hospital between 2006 and False lumen was thrombosed in 15 patients (71%). One patient underwent endovascular treatment because of persistent abdominal angina at 4 months after the onset. The other patients including three, whose true lumen of SMA were completely occluded by thrombosed false lumen, were successfully treated with conservative therapy. If occlusion of true lumen of the SMA is located closely to the ostium and is only short segment, collateral flow to distal SMA and early spontaneous recanalization of occluded segment will attribute to a successful conservative treatment. (J Jpn Coll Angiol 2015; 55: ) Online publication December 10, 2015 脈管学 Vol. 55

2012 Vol. 23 No pseudothrombophlebitis pseudothrombophlebitis

2012 Vol. 23 No pseudothrombophlebitis pseudothrombophlebitis pseudothrombophlebitis 5 424 163 38.1 26 6.1 5 1.2 230 2 3 66.4 51 80 2 3 2 2 1 2012 23 3 261-265 pseudothrombophlebitis 1 2011 7 11 30 2010 2 5 47 Fig. 1 Ultrasonography showed a low echoic cyst in the

脈管学55巻11号 pp

脈管学55巻11号　pp