介入栓塞治疗内脏动脉瘤的临床研究

Clinical Research on Endovascular Embolization in the Treatment of Visceral Artery Aneurysms

目的：探讨介入血管腔内栓塞治疗内脏动脉瘤的方法、疗效及安全性。方法：选择内脏动脉瘤患者23例,包括脾动脉瘤13例,肝动脉瘤2例,胃十二指肠动脉瘤3例,肠系膜上动脉瘤4例,肾动脉瘤1例。其中,9例行远近端动脉栓塞术,4例采用支架辅助弹簧圈瘤体内填塞,3例采用弹簧圈瘤体内填塞加瘤体内注胶栓塞术,4例行弹簧圈瘤体内栓塞术,2例行分支动脉颗粒栓塞术,1例行单纯注胶栓塞术。术后1月、3月、6月行超声、CTA或血管造影复查,以后每年复查一次。结果：本组均成功行介入血管腔内栓塞治疗内脏动脉瘤,栓塞治疗后造影示动脉瘤体和/或载瘤动脉闭塞,动脉瘤体内无明显对比剂显影,脾动脉瘤栓塞患者有3例出现发热,脾区疼痛等脾梗塞症状,未见栓塞术相关严重并发症发生。4例消化道出血患者出血均停止。术后随访3-48个月,未见动脉瘤破裂出血、动脉瘤复发或增大,支架置入者,支架内及分支动脉血流均保持通畅。结论：介入血管腔内栓塞是一种治疗内脏动脉瘤的简便、微创、安全有效的方法。

Objective： To evaluate the efficacy and safety of endovascular interventional techniques in the treatment of visceral artery aneurysms（VAA）. Methods： Twenty-three patients with VAAs were enrolled in the study, including 13 cases of splenic artery aneurysms, 2 cases of hepatic artery aneurysms, 3 cases of gastroduodenal aneurysms, 4 cases of superior mesenteric artery aneurysms and 1 case of renal artery aneurysm. Parent artery embolization was used for 9 cases of VAAs, stent grafts plus coil embolization was used for 4 VAAs, coiling plus glue embolization was used for 3 cases of VAAs, coiling only was used for 4 cases of VAAs, branch artery embolization was used for 2 cases of VAAs and glue embolization only was used for 1 case of VAA. Ultrasound, CTA or DSA follow-up was performed 1M, 3M and 6M after operation and annually thereafter. Results： The technique success rate was 100%. After treatment,immediate angiography showed occlusion of aneurysm sac or/and parent artery without any contrast filling within aneurysm sac. Splenic infarction symptoms including fever and pain were brought about after obliterating splenic artery aneurysms in 3 patients. No serious complications were found. Alimentary tract hemorrhage in 4 patients ceased after operation. There was no rupture, recurrence or enlargement of aneurysm during a 3-48 months＇ follow-up. The cases with stent grafts demonstrated a patency of stent and parent artery.Conclusion： Endovascular interventional embolization was an invasive, simple, safe and effective method for VAAs.