门静脉系统动脉瘤的自然历史
Mary A Binko1, Elizabeth A Andraska1, Katherine M Reitz1
1Division of Vascular Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA; Department of Surgery, University of Pittsburgh, Pittsburgh, PA.
Journal of vascular surgery. Venous and lymphatic disorders
|December 29, 2024
概括
门静脉系统动脉瘤 (PVA) 在监测期间通常是稳定的,大多数并没有显著增长. 虽然血栓形成发生在20%以上,但没有观察到破裂,这表明仔细监测是管理这些血管疾病的关键.
科学领域:
- 血管外科 血管外科
- 放射学 放射学是一门学科.
- 胃肠病学 胃肠病学
背景情况:
- 门静脉系统动脉瘤 (PVA) 越来越多地通过横截面成像检测.
- 关于PVA自然史的数据有限,之前的报道仅限于小型病例系列.
研究的目的:
- 为了研究门静脉系统动脉瘤的自然史和结果.
- 分析PVA的生长,回归,血栓形成和干预率.
主要方法:
- 对与PVA相关的术语进行放射学报告 (2010-2022) 的回顾性审查.
- 手动确认PVA存在和定义 (直径>1.5厘米没有肝硬化,>1.9厘米肝硬化).
- 动脉瘤生长 (>20%大小增加),回归 (>20%大小减少) 和相关患者因素的分析.
主要成果:
- 分析了35名患者的38个PVA,涉及门脉,脏脉和上半导体脉.
- 虽然31.6%是特异性,68.4%与门性高血压或肝移植有关.
- 13.2%的PVA回归 (主要是异形),34.2%增长 (与门高血压相关),23.7%发生血栓形成 (主要在男性中).
- 没有PVA破裂,但发生了3例有症状的血栓形成,导致所有确定的PVA中8.6%的干预.
结论:
- 三分之二的PVA,包括超过3厘米的PVA,在监测期间显示稳定性.
- 建议进行初始的年度监测,由于生长率低,可能会延长间隔.
- 尽管没有观察到破裂,但由于潜在的破裂后果,有症状的大型PVA值得考虑进行手术干预.
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