肝动脉化疗栓塞术后股动脉假性动脉瘤发生的影响因素

Risk factors related to femoral artery pseudoaneurysm after transhepatic arterial chemoembolization

目的 :股动脉假性动脉瘤(femoral artery pseudoaneurysm,FAP)是经股动脉进行介入诊断及治疗的局部并发症。目前针对FAP的研究主要集中于心导管术后FAP的发生,但对于肝癌患者行经股动脉肝动脉化疗栓塞术(transhepatic arterial chemoembolization,TACE)治疗后的FAP发生率及潜在影响因素的相关研究还较少。本研究旨在探讨TACE治疗后与FAP发生及其治疗疗效相关的潜在影响因素。方法 :研究对象为2010年1月—2015年6月在复旦大学附属中山医院肝肿瘤内科行TACE治疗的肝癌患者5 389例,其中11例患者发生FAP。对TACE治疗后FAP发生的相关影响因素及其临床特点以及不同治疗方法的疗效及其影响因素进行分析。结果 :5 389例肝癌患者接受12 222例次TACE治疗后的FAP发生率为0.09%(11/12 222)。高龄、男性、罹患高血压和(或)糖尿病以及肥胖是FAP发生的潜在危险因素。本研究中,FAP首选治疗方法——超声引导下加压包扎保守治疗的成功率为63.64%(7/11)。高龄、女性、FAP瘘口直径和周围血管疾病史是影响FAP治疗疗效的相关因素(P值均<0.05)。结论 :高龄、男性、罹患高血压和(或)糖尿病以及肥胖是TACE治疗后FAP发生的潜在危险因素。高龄、女性、FAP瘘口直径和周围血管疾病史是影响FAP治疗疗效的相关因素。

Objective：Femoral artery pseudoaneurysm（FAP） is a troublesome complication after transfemoral catheter procedures.The previous studies mainly focused on the FAP of post-cardiac catheterization.However,the studies on FAP after transhepatic arterial chemoembolization（TACE） in liver cancer patients are rare.This study was designed to explore the potential predicators of post-TACE FAP and the influencing factors related to its curative effect.Methods：This was a retrospective study including 5 389 patients with hepatic cancer undergoing 1 2 222 times of TACE between January,201 0 and June,201 5 in Department of Hepatic Oncology,Zhongshan Hospital,Fudan University.Totally 1 1 FAPs after TACE were found and confirmed by duplex ultrasound.The potential predicators and clinical characteristics of FAP were analyzed.The influencing factors related to treatment effectiveness for FAP were also analyzed.Results：The incidence rate of post-TACE FAP was 0.09%（11/12 222）.Elderly（ 〉60 years old）,male,hypertension and（or） diabetes and obesity were potential risk factors for FAP occurrence.The success rate of ultrasound-guided compression which was the preferred treatment for FAP was 63.64%（7/11）.Elderly,female,the greater diameter of FAP fistula and the history of hypertension and（or） diabetes were related to poor effectiveness of ultrasound-guided compression for FAP（all P〈0.05）.Conclusion：The results of this study indicates that elderly,male,hypertension and（or）diabetes and obesity were potential risk factors for FAP occurrence,meanwhile the elderly,female,the greater diameter of FAP fistula and the history of hypertension and（or） diabetes are related to poor effectiveness of ultrasound-guided compression for FAP.