{"title":"一例因胰腺癌侵犯肠系膜上动脉导致小肠缺血而进行肠系膜上动脉支架植入术的病例。","authors":"Hiroshi Kuwamura, Yohsuke Suyama, Yasuhiro Enjoji, Takahiro Einama, Yoji Kishi, Hiroshi Shinmoto","doi":"10.1093/bjrcr/uaae031","DOIUrl":null,"url":null,"abstract":"<p><p>Superior mesenteric artery (SMA) invasion by a malignant tumour is a serious condition leading to intestinal ischaemia. Although SMA stenting has been reported to be useful for SMA dissection and stenosis caused by atherosclerotic plaque, SMA stenting for stenosis caused by malignant tumour invasion is rarely reported and uncertain. A 75-year-old woman presented intestinal ulcer and melena caused by SMA invasion of unresectable pancreatic cancer. The bare metal stent was implanted for the vessel stenosis, and a small intestinal ulcer was markedly improved after stenting. However, one and a half months after stenting the stent was occluded and a thrombectomy was performed. After thrombectomy, residual stenosis caused by tumour invasion was observed in the stent. The patient suddenly died 2 days after thrombectomy before additional covered stenting for residual stenosis. Stent implantation may be a treatment option for intestinal ischaemia caused by vessel invasion of malignant tumours. On the other hand, re-stenosis of the stent due to tumour ingrowth is a problem, and covered stenting is considered for long-term stent patency.</p>","PeriodicalId":45216,"journal":{"name":"BJR Case Reports","volume":null,"pages":null},"PeriodicalIF":0.5000,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11368407/pdf/","citationCount":"0","resultStr":"{\"title\":\"A case of superior mesenteric artery stenting for small intestinal ischaemia caused by superior mesenteric artery invasion of pancreatic cancer.\",\"authors\":\"Hiroshi Kuwamura, Yohsuke Suyama, Yasuhiro Enjoji, Takahiro Einama, Yoji Kishi, Hiroshi Shinmoto\",\"doi\":\"10.1093/bjrcr/uaae031\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Superior mesenteric artery (SMA) invasion by a malignant tumour is a serious condition leading to intestinal ischaemia. Although SMA stenting has been reported to be useful for SMA dissection and stenosis caused by atherosclerotic plaque, SMA stenting for stenosis caused by malignant tumour invasion is rarely reported and uncertain. A 75-year-old woman presented intestinal ulcer and melena caused by SMA invasion of unresectable pancreatic cancer. The bare metal stent was implanted for the vessel stenosis, and a small intestinal ulcer was markedly improved after stenting. However, one and a half months after stenting the stent was occluded and a thrombectomy was performed. After thrombectomy, residual stenosis caused by tumour invasion was observed in the stent. The patient suddenly died 2 days after thrombectomy before additional covered stenting for residual stenosis. Stent implantation may be a treatment option for intestinal ischaemia caused by vessel invasion of malignant tumours. On the other hand, re-stenosis of the stent due to tumour ingrowth is a problem, and covered stenting is considered for long-term stent patency.</p>\",\"PeriodicalId\":45216,\"journal\":{\"name\":\"BJR Case Reports\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.5000,\"publicationDate\":\"2024-08-26\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11368407/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"BJR Case Reports\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1093/bjrcr/uaae031\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/9/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q4\",\"JCRName\":\"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"BJR Case Reports","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1093/bjrcr/uaae031","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/9/1 0:00:00","PubModel":"eCollection","JCR":"Q4","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
引用次数: 0
摘要
恶性肿瘤侵犯肠系膜上动脉(SMA)是导致肠缺血的一种严重情况。尽管有报道称 SMA 支架植入术可用于动脉粥样硬化斑块引起的 SMA 夹层和狭窄,但针对恶性肿瘤侵犯引起的 SMA 支架植入术却鲜有报道,且效果并不确定。一名 75 岁的妇女因无法切除的胰腺癌侵犯 SMA 而出现肠溃疡和腹泻。针对血管狭窄植入了裸金属支架,支架植入后小肠溃疡明显好转。然而,支架植入一个半月后出现闭塞,于是进行了血栓切除术。血栓切除术后,发现支架因肿瘤侵犯而残留狭窄。血栓切除术后 2 天,患者突然死亡,随后对残余狭窄进行了额外的覆盖支架植入术。对于恶性肿瘤侵犯血管导致的肠道缺血,支架植入可能是一种治疗选择。另一方面,由于肿瘤生长导致的支架再狭窄也是一个问题,为了保证支架的长期通畅,需要考虑覆盖支架。
A case of superior mesenteric artery stenting for small intestinal ischaemia caused by superior mesenteric artery invasion of pancreatic cancer.
Superior mesenteric artery (SMA) invasion by a malignant tumour is a serious condition leading to intestinal ischaemia. Although SMA stenting has been reported to be useful for SMA dissection and stenosis caused by atherosclerotic plaque, SMA stenting for stenosis caused by malignant tumour invasion is rarely reported and uncertain. A 75-year-old woman presented intestinal ulcer and melena caused by SMA invasion of unresectable pancreatic cancer. The bare metal stent was implanted for the vessel stenosis, and a small intestinal ulcer was markedly improved after stenting. However, one and a half months after stenting the stent was occluded and a thrombectomy was performed. After thrombectomy, residual stenosis caused by tumour invasion was observed in the stent. The patient suddenly died 2 days after thrombectomy before additional covered stenting for residual stenosis. Stent implantation may be a treatment option for intestinal ischaemia caused by vessel invasion of malignant tumours. On the other hand, re-stenosis of the stent due to tumour ingrowth is a problem, and covered stenting is considered for long-term stent patency.