腹腔内脏血管动脉瘤的介入治疗方法探讨

Interventional treatment of visceral aneurysms:an investigation of therapeutic technique

目的探索腹腔内脏动脉动脉瘤的介入治疗方法。方法进行介入治疗的9例内脏动脉动脉瘤患者,总共11枚动脉瘤,其中1例为肠系膜上动脉主干部动脉瘤合并右侧结肠动脉动脉瘤,1例为2枚脾动脉瘤,另外还有5例各1枚脾动脉瘤,1例胃右动脉瘤,1例肝动脉假性动脉瘤。使用弹簧圈分别成功对6例脾动脉瘤患者的7枚脾动脉瘤及1枚右侧结肠动脉瘤,1枚胃右动脉瘤,1枚肝动脉假性瘤进行了栓塞,1例肠系膜上动脉动脉瘤的使用覆膜支架植入隔离动脉瘤。结果所有患者均治疗成功,未出现相关并发症。肠系膜上动脉动脉瘤植入支架后瘤腔被完全封闭,肠系膜上动脉主干通畅。结论介入栓塞技术可以成功栓塞大部分内脏动脉动脉瘤,对于部分栓塞困难者可以使用覆膜支架隔绝动脉瘤。

Objective To evaluate interventional techniques for the treatment of visceral aneurysms. Methods A total of 11 aneurysms were found in 9 patients with visceral aneurysms who received interventional treatment. Of the 9 patients, single aneurysm at both superior mesenterie artery （SMA） and right colonic artery was seen in one, 2 aneurysms at same splenic artery in one, one aneurysm at splenic artery in 5, aneurysm at right gastric artery in one and pseudoaneurysm at hepatic artery in one. In 9 patients the transcatheter endovaseular coil embolization was successfully carried out for 10 aneurysms, including splenic （n = 7）, right colonic artery （n = 1）, right gastric artery （n = 1） and hepatic pseudoaneurysm （n = 1）. One stent-graft was used for the SMA aneurysm. Results Technical success was achieved in all cases without any serious complications. Conclusion Interventional embolization with coils can successfully occlude most visceral aneurysms, while stent-graft should be used when the aneurysm is difficult to be occluded with coil. （J Intervent Radio/, 2009, 18： 90-92）