超声指导下冠状动脉介入术后股动脉假性动脉瘤的诊断和治疗

Diagnosis and treatment of femoral after pseudo aneurism occurred after coronary artery intervention procedure

目的探讨超声指导下冠状动脉介入术后股动脉假性动脉瘤的发生原因、临床表现、诊断及治疗方法。方法采用超声引导下压迫修复的方法，失败的病例选择超声引导下注射凝血酶。结果经超声检查确诊冠状动脉介入术后股动脉假性动脉瘤的39例患者中有18例经压迫修复治愈，平均压迫时间（36．78±1．71）rain。21例经压迫修复失败后采用瘤腔内注射凝血酶治愈，平均瘤内血栓形成时间（0．33±0．06）min。所有患者均于修复后24h复查超声，证实假性动脉瘤已闭合。术后随诊半年，未见假性动脉瘤复发。结论冠状动脉介入术后引发股动脉假性动脉瘤，在超声引导下压迫修复和超声引导下行腔内注入凝血酶是安全有效的治疗方法。

Objective To explore the causes, clinical manifestations, diagnosis and treatment method of femoral artery pseudoaneurysms （IFPSA） after ultrasound-guided percutaneous coronary intervention. Methods Ultrasound-guided repair by compression was applied to all cases, of which the failed cases were treated with ultrasound-guided thrombin injection. Results IFPSA was confirmed by ultrasound imaging in 39 cases, 18 of which were cured by compression repair,with the average compression duration of （36. 78 ± 1.71 ）min. Another 21 cases were cured by the thrombin injection, after compression repair failed,with average time for thrombosis （0. 33 ± 0. 06 ）min. All the patients were re-evaluated by ultrasound 24 h after treatment, confirming the successful closure of the pseudoaneurysms. No recurrence of pseudoaneurysm was observed during a half-year post-operative follow-up. Conclusion Ultrasound-guided compression renair and ultrasound-guided thrnrnhln injection into the cavity are safe and effective treatments for femoral arterial pseudoaneurysms after coronary intervention.