内脏动脉瘤的介入治疗(附10例报道)

Interventional treatment for visceral artery aneurysms: analysis of 10 cases

目的探讨内脏动脉瘤(VAAS)的介入治疗方法,总结分析经导管栓塞VAAS的疗效。方法回顾分析10例采用弹簧圈、微弹簧圈及明胶海绵等栓塞材料介入栓塞治疗VAAS的临床资料。1例脾、胰横动脉多发动脉瘤栓塞流入、流出动脉及'三明治'栓塞法;1例脾中段巨大动脉瘤栓塞流入、流出动脉+填塞瘤腔;1例肝右动脉医源性假性动脉瘤及1例左支气管动脉瘤栓塞流入动脉+填塞瘤腔。1例带颈肝动脉瘤单纯填塞瘤腔。5例医源性肾假性动脉瘤单纯栓塞流入动脉。结果 9例VAAS均一次栓塞成功,但1例肝右动脉假性动脉瘤破裂出血,再次栓塞成功止血。所有病例术后随访2~30个月,无严重并发症出现,动脉瘤未复发。结论经导管置入弹簧圈栓塞VAAS安全有效。

Objective To evaluate the interventional treatment for visceral artery aneurysms( VAAs) with catheter based techniques. Methods The clinical data of 10 patients with VAAs from Feb. 2004 to Oct. 2013 were retrospectively analyzed. The materials of embolization were spring coil,GDC,gelatin sponge. Interventional embolization was performed in 1patient with multiple aneurysms of splenic artery and transverse pancreatic artery in the way of ' sandwich pattern'. Embolization of both efferent and afferent arteries of the aneurysm associating with coil embolization was performed in 1 patient with large aneurysm at the middle segment of splenic artery. Embolization of efferent artery of the aneurysm associating with coil embolization was performed in 1 iatrogenic pseudoaneurysm of right hepatic artery and one aneurysm in left bronchial artery. Mere coil embolization was performed in 1hepatic aneurysm with narrow neck. Embolization of efferent artery of the aneurysm was performed in 5 iatrogenic pseudoaneurysms of renal artery. Results Technical success was achieved in 9 cases,but 1 iatrogenic pseudoaneurysm of right hepatic artery was embolized two times because of rupture. During 2 ~ 30 months' follow- up,no significant complications were recorded,and no aneurysms recurred. Conclusion Transcatheter endovascular interventional techniques are safe and effective treatment for visceral artery aneurysms.