内脏假性动脉瘤出血的栓塞治疗

Transcatheter arterial embolization for the treatment of visceral pseudoaneurysmal bleeding

目的探讨内脏假性动脉瘤出血经导管栓塞治疗的方法及疗效。方法回顾性分析7例以不同部位出血为主要表现的患者,行腹、盆腔相关动脉造影,明确出血原因为假性动脉瘤及其部位后行栓塞治疗。结果7例中,肝动脉瘤2例,胃十二指肠动脉瘤3例,子宫动脉瘤2例。动脉造影能够清晰显示假性动脉瘤的部位、形态和供养血管。DSA造影动脉瘤呈现类圆形囊状突起,栓塞后再次造影见动脉瘤及其供血动脉消失,7例介入治疗均获成功。所有术后出血均停止。结论DSA造影能明确假性动脉瘤的部位,经导管栓塞治疗假性动脉瘤是安全有效的。

Objective To discuss the technical points and clinical efficacy of transcatheter arterial embolization in the treatment of visceral pseudoaneurysmal bleeding. Methods Transcatheter arterial embolization was performed in 7 patients with bleeding in different sites due to ruptured visceral pseudoaneurysms. The procedure was carried out after the diagnosis which was confirmed with abdominal or pelvic angiography. The clinical data and imaging findings were retrospectively analyzed. Results Of 7 patients, hepatic pseudoaneurysm was seen in 2, gastroduodenal pseudoaneurysm in 3 and uterine pseudoaneurysm in 2. The site, shape and the feeding vessels of the pseudoaneurysms were well demonstrated on angiographs. On DSA, the pseudoaneurysm was manifested as a round sack-like bulge, which, together with its feeding vessels, disappeared after embolization. Technical success was obtained in all 7 patients, and the bleeding stopped immediately. Conclusion DSA can clarify the site of pseudoaneurysm and transcatheter arterial embolization is a safe and effective technique for the treatment of visceral pseudoaneurysmal bleeding.