血管损伤的腔内治疗体会

Management of vascular trauma by endovascular intervention

目的：探讨腔内血管修复技术治疗血管损伤中的可行性及其疗效。方法：回顾性分析我科2002年6月至2006年8月诊治的血管外伤患者37例中12例接受血管腔内治疗患者的住院和随访资料。12例患者主要的血管病变类型是动静脉瘘、夹层形成、假性动脉瘤和动脉狭窄。其中1例采用球囊扩张合并血管支架植入,其余11例采用覆膜型血管支架植入。结果：技术成功率100％,无围手术死亡和严重并发症,术后症状全部改善。平均随访时间11．5个月。随访期间内无支架移位、内漏、支架内狭窄等并发症。结论：腔内治疗是一种新兴的治疗血管外伤的手段,与传统手术相比具有微创、安全等优点,短期随访效果满意,长期效果仍需继续观察。

Objective To evaluate the feasibility and efficacy of endovascular intervention in treating arterial trauma. Methods During the period from Jun. 2002 to Aug. 2006, a total of 37 consecutive cases of vascular trauma, including arteriovenous fistula, pseudoaneurysm, arterial wall dissection and post-traumatic arterial stenosis, were admitted into our department, 12 of them （10 males and 2 females, with an average age of 37 years） underwent various endovascular intervention. Endovascular stents or stent-grafts were implanted to repair the vascular impairment and re-establish the bloodflow. Results The interventional procedures were successful in all cases, without peri-operative death and major complications. The symptoms were ameliorated after the endovascular interventions. Eleven patients were followed up for an average of 11.5 months. No stent migration, endoleakage or stent restenosis occurred. Concluions Endovascular intervention is a new therapeutic approach with advantages of safety, effectiveness and minimal invasiveness. Its long-term efficacy needs to be further evaluated.