切换至 "中华医学电子期刊资源库"

中华介入放射学电子杂志 ›› 2020, Vol. 08 ›› Issue (04) : 321 -325. doi: 10.3877/cma.j.issn.2095-5782.2020.04.006

所属专题: 总编推荐 文献

血管介入

超选择载瘤动脉栓塞术治疗腹腔非主干动脉假性动脉瘤破裂出血
李明明1, 陈珑1,(), 姜小庆1, 李智1, 倪才方1   
  1. 1. 215006 江苏苏州,苏州大学附属第一医院介入科
  • 收稿日期:2020-09-29 出版日期:2020-11-25
  • 通信作者: 陈珑

Superselective parent artery embolization for the treatment of ruptured-abdominal pseudoaneurysm on branched artery

Mingming Li1, Long Chen1,(), Xiaoqing Jiang1, Zhi Li1, Caifang Ni1   

  1. 1. Department of Interventional Radiology, the First Affiliated Hospital of Soochow University, Jiangsu Suzhou 215006, China
  • Received:2020-09-29 Published:2020-11-25
  • Corresponding author: Long Chen
  • About author:
    Corresponding author: Chen Long, Email:
引用本文:

李明明, 陈珑, 姜小庆, 李智, 倪才方. 超选择载瘤动脉栓塞术治疗腹腔非主干动脉假性动脉瘤破裂出血[J/OL]. 中华介入放射学电子杂志, 2020, 08(04): 321-325.

Mingming Li, Long Chen, Xiaoqing Jiang, Zhi Li, Caifang Ni. Superselective parent artery embolization for the treatment of ruptured-abdominal pseudoaneurysm on branched artery[J/OL]. Chinese Journal of Interventional Radiology(Electronic Edition), 2020, 08(04): 321-325.

目的

探讨超选择载瘤动脉栓塞术治疗腹腔非主干动脉假性动脉瘤破裂出血的临床疗效及安全性。

方法

回顾性分析2017年2月至2020年6月采用超选择栓塞治疗的腹腔内非主干动脉假性动脉瘤破裂出血患者临床资料,分析止血效果及并发症,总结治疗经验。

结果

21例患者均使用微导管超选择至假性动脉瘤的载瘤动脉以微弹簧圈行栓塞治疗,其中10例联合明胶海绵颗粒进行巩固栓塞。21例患者中18例患者栓塞假性动脉瘤的载瘤动脉近端血管,3例患者于假性动脉瘤载瘤动脉的远端和近端行"三明治"栓塞,技术成功率100%(21/21),初次栓塞的临床成功率81.0%(17/21),二次栓塞后总体临床成功率为85.7%(18/21)。4例患者术后有一过性轻度腹痛,1例患者发生脾脏部分梗死,予对症抗炎治疗后好转。

结论

超选择载瘤动脉栓塞术治疗腹腔非主干动脉假性动脉瘤破裂出血成功率高、可重复性强,是一种可供选择的治疗方法。合理选择栓塞材料可达到较好的止血效果并降低并发症的发生。

Objective

To investigate the clinical efficacy and safety of superselective parent artery embolization in the treatment of ruptured-abdominal pseudoaneurysm on branched artery.

Methods

The clinical data of patients with ruptured-abdominal pseudoaneurysm on branched artery treated by superselective parent artery embolization from February 2017 to June 2020 were retrospectively analyzed. The hemostatic effect and complications were analyzed, and the clinical experience was summarized.

Results

All the21 patients received superselective parent artery embolization with micro-coils. Among them, 10 patients were embolized with gelfoam particles additionally for consolidated embolization. 18 patients were embolized at the proximal part of the parent artery and 3 patients were treated with "sandwich" embolization technique. The technical success rate was 100% (21/21). The clinical success rate of primary embolization was 81.0% (17/21), and the overall clinical success rate after secondary embolization was 85.7% (18/21). Transient mild abdominal pain was observed in 4 patients and partial splenic infarction occurred in 1 patient after embolization. All the sympotoms relieved after treatment.

Conclusions

Superselective parent artery embolization is of high success rate and easy to repeat. It is an alternative treatment for ruptured-abdominal pseudoaneurysm on branched artery. Reasonable selection of embolic materials can achieve better hemostasis effect and reduce the incidence of complications.

图1 患者,女,56岁,ERCP术后29 d,急性胰腺炎伴腹腔内出血5 h
表1 3例栓塞治疗失败患者临床资料表
[1]
Saad NE, Saad WE, Davies MG, et al. Pseudoaneurysms and the role of minimally invasive techniques in their management[J]. Radiographics, 2005, 25 Suppl 1: S173-S189.
[2]
Madhusudhan KS, Venkatesh HA, Gamanagatti S, et al. Interventional radiology in the management of visceral artery pseudoaneurysms: a review of techniques and embolic materials[J]. Korean Journal of Radiology, 2016, 17(3): 351.
[3]
Sousa J, Costa D, Mansilha A. Visceral artery aneurysms: review on indications and current treatment strategies[J]. International angiology, 2019, 38(5): 381.
[4]
Lu M, Weiss C, Fishman EK, et al. Review of visceral aneurysms and pseudoaneurysms[J]. Journal of Computer Assisted Tomography, 2015, 39(1): 1-6.
[5]
Cordova AC, Sumpio BE. Visceral artery aneurysms and pseudoaneurysms-should they all be managed by endovascular techniques?[J]. Annals of Vascular Diseases, 2013, 6(4): 687-693.
[6]
余宏建,林佳钿,陈在中, 等. Glubran-2胶联合弹簧圈栓塞治疗外科术后内脏假性动脉瘤[J]. 放射学实践, 2019, 34(01): 65-69.
[7]
周坦洋,孙军辉,张岳林, 等. 胰十二指肠术后出血的DSA诊断及动脉栓塞治疗[J]. 中华医学杂志, 2015, 95(05): 368-370.
[8]
Wellner UF, Kulemann B, Lapshyn H, et al. Postpancreatectomy hemorrhage-incidence, treatment, and risk factors in over 1,000 pancreatic resections[J]. J Gastrointest Surg, 2014, 18(3): 464-475.
[9]
Jesinger RA, Thoreson AA, Lamba R. Abdominal and pelvic aneurysms and pseudoaneurysms: imaging review with clinical, radiologic, and treatment correlation[J]. RadioGraphics, 2013, 33(3): E71-E96.
[10]
刘敬禹,宋涛,王卫星, 等. 动脉造影栓塞对急性消化道出血的诊疗价值[J]. 介入放射学杂志, 2015, 24(02): 114-117.
[11]
江广斌,梁惠民. 动脉性消化道出血的DSA诊断及介入栓塞治疗[J]. 临床放射学杂志, 2006(09): 881-883.
[12]
谢坪,李刚,于翔. α-氰基丙烯酸正丁酯超选择动脉栓塞治疗血管发育不良性下消化道出血7例[J]. 介入放射学杂志, 2016, 25(02): 167-170.
[1] 马桥桥, 张传开, 郭开今, 蒋涛, 王子豪, 刘勇, 郝亮. 可降解止血粉减少初次全膝关节置换术失血量的研究[J/OL]. 中华关节外科杂志(电子版), 2024, 18(05): 585-589.
[2] 张秋阳, 余韶芸, 潘向滢, 金家佳, 夏桦, 赵雪红. 成年体外膜肺氧合患者出血影响因素的Meta 分析[J/OL]. 中华危重症医学杂志(电子版), 2024, 17(05): 392-398.
[3] 张舒沁, 陈练. 产后宫腔内妊娠物残留的诊断和临床处理[J/OL]. 中华妇幼临床医学杂志(电子版), 2024, 20(05): 493-497.
[4] 李霞林, 贺芳. 产后出血风险评估和早期预警系统[J/OL]. 中华妇幼临床医学杂志(电子版), 2024, 20(05): 498-503.
[5] 李小飞, 刘洪莉, 石丘玲, 田静, 李莉, 漆洪波, 罗欣. 自然分娩产妇低强度聚焦超声子宫复旧治疗防治产后出血的前瞻性随机对照研究[J/OL]. 中华妇幼临床医学杂志(电子版), 2024, 20(05): 534-539.
[6] 周正阳, 陈凯, 仇多良, 邵乐宁, 吴浩荣, 钟丰云. 腹腔镜腹股沟疝修补术后出血原因分析及处理[J/OL]. 中华疝和腹壁外科杂志(电子版), 2024, 18(06): 660-664.
[7] 杭轶, 杨小勇, 李文美, 薛磊. 可控性低中心静脉压技术在肝切除术中应用的最适中心静脉压[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(06): 813-817.
[8] 王永楠, 汤畅通, 殷杰, 谭溢涛. 微创钻孔引流术与神经内镜血肿清除术治疗临界量基底节脑出血的效果对比分析[J/OL]. 中华神经创伤外科电子杂志, 2024, 10(05): 286-292.
[9] 张志超, 李陈, 韩惠, 周夏, 洪家康. 经额平行白质纤维束立体定向血肿穿刺引流术与神经内镜下血肿清除术治疗基底节脑出血的临床对比分析[J/OL]. 中华神经创伤外科电子杂志, 2024, 10(05): 299-303.
[10] 李晓东, 王汉宇, 马龙, 刘亮, 魏云, 李昂. 小脑后下动脉瘤的显微手术治疗[J/OL]. 中华脑科疾病与康复杂志(电子版), 2024, 14(05): 318-320.
[11] 吴广迎, 张延娟, 秦鹏, 卢艳丽. 经颈静脉肝内门体静脉分流术预防上消化道出血的临床研究[J/OL]. 中华消化病与影像杂志(电子版), 2024, 14(06): 545-548.
[12] 梁艳娉, 陈燕柔, 梁运啸, 白飞虎, 吴斌, 王省. 华南地区门静脉高压食管胃静脉曲张出血内镜治疗现状调研分析[J/OL]. 中华消化病与影像杂志(电子版), 2024, 14(05): 390-395.
[13] 董晟, 郎胜坤, 葛新, 孙少君, 薛明宇. 反向休克指数乘以格拉斯哥昏迷评分对老年严重创伤患者发生急性创伤性凝血功能障碍的预测价值[J/OL]. 中华临床医师杂志(电子版), 2024, 18(06): 541-547.
[14] 穆巴拉克·伊力哈, 徐霁华, 鲁明. 急性轻型卒中微量脑出血误诊病例的临床特点及影像学表现分析[J/OL]. 中华脑血管病杂志(电子版), 2024, 18(05): 441-445.
[15] 赵伟伟, 赵玉华, 刘小璇. 西藏地区亚甲基四氢叶酸还原酶C677T多态性及其与脑微出血的相关性[J/OL]. 中华脑血管病杂志(电子版), 2024, 18(05): 473-478.
阅读次数
全文


摘要


AI


AI小编
你好!我是《中华医学电子期刊资源库》AI小编,有什么可以帮您的吗?