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首页> 外文期刊>CVIR Endovascular >Spontaneous rupture of the pancreatic arcade artery caused by neurofibromatosis type 1 successfully treated using emergency transcatheter arterial embolization, partial intra-aortic balloon occlusion, and stent graft placement: a case report and review of the literature
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Spontaneous rupture of the pancreatic arcade artery caused by neurofibromatosis type 1 successfully treated using emergency transcatheter arterial embolization, partial intra-aortic balloon occlusion, and stent graft placement: a case report and review of the literature

机译：由神经纤维瘤病1型胰腺拱廊动脉的自发破裂成功处理了应急转基因动脉栓塞，部分主动脉气球闭塞和支架移植物放置：案例报告和文献审查

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Vascular abnormalities in neurofibromatosis type 1 (NF1) are rare, but are the second leading cause of death in persons with NF1. In NF1 vasculopathy (NF-V), fatal bleeding due to a spontaneous arterial rupture sometimes occurs. Ruptured extracranial arteries in patients with NF1 often involve thoracic vessels, such as the intercostal and subclavian arteries; very few reports exist regarding the abdominal region. Herein, we present the first case of intraperitoneal bleeding due to spontaneous pancreatic arcade artery (PAA) rupture associated with NF1, successfully treated by transcatheter arterial embolization (TAE) combined with stent-graft placement and partial intra-aortic balloon occlusion (IABO). A 40-year-old woman complained of back and abdominal pain. Upon admission, her blood pressure was 85/41?mmHg and heart rate was 129 beats/min. Computed tomography (CT) showed large intraperitoneal bleeding due to PAA rupture. After CT scanning, her systolic blood pressure decreased to 50?mmHg. Therefore, we performed emergency TAE with partial IABO. She was treated by TAE of the anterior superior pancreaticoduodenal artery, anterior inferior pancreaticoduodenal artery, and inferior pancreaticoduodenal artery. However, even after TAE, minor extravasation around the superior mesenteric artery continued, and her vital signs remained unstable. Stent-graft placement was selected to stop the haemorrhage, preserving normal blood flow of the superior mesenteric artery trunk. Excellent patency of the stent graft was confirmed on follow-up CT, and she was discharged on postoperative day 56. PAA rupture associated with NF1 can be successfully treated by TAE combined with partial intra-aortic balloon occlusion, and stent-graft placement.
机译：神经纤维瘤病1型（NF1）中的血管异常是罕见的，但是NF1人类死亡的第二个主要原因。在NF1血管病（NF-V）中，有时会发生由于自发性动脉破裂引起的致命出血。 NF1患者的破裂颅内动脉通常涉及胸部血管，例如肋间和锁骨期动脉;关于腹部地区的报道很少。这里，我们介绍了由于与NF1相关的自发性胰腺拱廊动脉（PAA）破裂的第一种腹膜内出血的情况，通过经截管动脉栓塞（TAE）与支架移植物放置和部分内变气管闭塞（IABO）联合治疗。一个40岁的女性抱怨背部和腹痛。入院后，她的血压为85/41？mmhg和心率为129次/分钟。计算机断层扫描（CT）由于PAA破裂而显示出大的腹膜内出血。 CT扫描后，其收缩压降至50？mmHg。因此，我们用部分IABO进行了紧急TAE。她是由前期胰腺细胞腺癌，前期胰腺癌动脉和较差的胰腺癌动脉治疗。然而，即使在TAE之后，仍在围绕上肠系膜动脉的微细化，并且她的生命体征仍然不稳定。选择支架移植物放置以停止出血，保留上肠系膜动脉躯干的正常血流。在随访CT上确认支架移植物的优异通畅，她在术后第56天出院。与NF1相关的PAA破裂可以通过TAE成功处理与部分主动脉闭塞和支架移植物放置。

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