脑血管病介入术后股动脉假性动脉瘤的临床分析及治疗

Clinical analysis and treatment of Femoral artery pseudoaneurysm after Neuroendovascular Interventions for Stroke

目的探讨脑血管病介入术后股动脉假性动脉瘤发生率、发生原因和治疗效果。方法分析395例脑血管病介入术后发生股动脉假性动脉瘤患者临床资料和治疗情况。结果共有5例患者发生股动脉假性动脉瘤,发生率1.2%,均为单纯全脑血管造影术患者;1例患者过早下床活动;1例穿刺误入股浅动脉;3例假性动脉瘤患者伴原发性高血压病,其中1例患者术后血压仍然未得到有效控制。5例患者均经超声引导下徒手压迫,4例治愈,1例无效后改用在超声引导下假腔内注射凝血酶治愈。结论肝素化、过早活动、高血压病、不规范的穿刺技术是脑血管病介入术后股动脉假性动脉瘤产生的危险因素,超声引导下局部压迫和假腔内注射凝血酶是治疗假性动脉瘤的有效措施。

Objective To investigate incidence, cause and treatment of femoral pseudoaneurysms after neuroendovascular interventions for cerebral vascular disease. Methods Analysis of clinical characteristic and the effects of treatment were done among 5 patients with Femoral artery pseudoaneurysms in 395 patients. Re- suits 05 in 395 patients suffered with femoral artery pseudoaneurysm, which incidence was i. 2 percent, all patients suffered with Cerebral vascular angiography. 1 patients exercising early. 1 patient puncture in superfi- cial femoral artery by mistake. 3 in 5 patients with femoral artery pseudoaneurysms had hypertension, Among them 1 case of patients with postoperative blood pressure is still not under control. All 5 patients with femoral pseudoneurysm were well healed, 4 by ultrasound-guided compression repair （UGCR）, 1 by ultrasound guided thrombin injection into the pseudoaneurysm （UGTI） after invalid UGCR. Conclusions Heparinization, early exercise, hypertension and non-standard puncture technique are risk factors of femoral artery pseudoaneurysm post neuroendovascular interventions for cerebral vascular disease. UGCR and UGTI is effective on femoral ar- tery pseudoaneurysn.