经血管腔内治疗21例内脏动脉瘤的临床疗效

Transcather Endovascular Treatment of Visceral Artery Aneurysms:Clinical Outcome of 21 Patients

目的:评价血管腔内治疗内脏动脉瘤的安全性及疗效。方法:回顾总结经血管腔内治疗21例内脏动脉瘤患者的资料;其中男性15例,女性6例;年龄23～72岁(平均49岁);真性动脉瘤17例,假性动脉瘤9例(医源性8例,创伤后1例);瘤体位于脾动脉10例,肝动脉7例,肾动脉4例,肠系膜动脉3例,胃左动脉1例,腹腔动脉1例。17例行经导管动脉瘤体栓塞术+载瘤动脉栓塞术;4例行覆膜支架植入术;1例联合行动脉瘤体栓塞术+支架植入术;3例瘤体直径<2cm的动脉瘤未干预。结果:21例患者手术成功率为100%,除2例出现轻度脾梗死症状外,未见明显手术并发症。术后随访5～42个月(平均19.1个月)未见动脉瘤破裂出血、动脉瘤复发或增大;支架内及分支动脉血流均保持通畅;3例未干预动脉瘤者未见动脉瘤增大及相关并发症。结论:经血管腔内栓塞或覆膜支架植入术治疗内脏动脉瘤安全、有效。

Objective： To evaluate transcatheter endovascular interventional techniques in treatment of visceral artery aneurysms（VAAs）. Methods： Patient records were retrospectively reviewed between 2000 and 2008 for VAA cases treated with catheter-based techniques in our department. 21 patients （6 women; mean age 49 ± 26 years） with 26 （9 false and 17 true） VAAs were identified,of which 10 involved the splenic artery,7 hepatic,4 renal, 3 superior mesenteric, I left gastric and 1 celiac. Transcatheter endovascular coil embolization was used in 17 VAAs. Stent graft placements were used to treat 4 patients. Combination of the endovascular embolization and stent placement in the SMA was performed in 1 patient with SMA areurysm. 3 VAAs which diameter shorter than 2 centimeters were kept observed. Results： Technical success was achieved in all cases with no significant complications except for slight symptoms of splenic infarction. An average follow-up of 19.1 months revealed no recurrence of areurysms and Doppler ultrasound scan showed patency of stent grafts. 3 uninterfered VVAs showed no augmentation and complications. Conclution：Transcatheter endovascular interventional techniques are safe and effective methods for the treatment of visceral artery aneurysms.