Glubran-2胶联合弹簧圈栓塞治疗外科术后内脏假性动脉瘤

Transcatheter arterial embolization using glubran-2 glue in combination with coils for the treatment of postoperative visceral pseudoaneurysm

目的:评价Glubran-2胶联合弹簧圈经导管动脉栓塞治疗内脏假性动脉瘤的临床疗效和安全性。方法:12例开放手术后腹腔假性动脉瘤患者行DSA血管造影,并采用Glubran-2胶联合弹簧圈行栓塞治疗,分析12例患者的止血效果及栓塞后并发症。结果:12例假性动脉瘤中位于胃十二指肠动脉主干和分支4例,肝左动脉分支2例,肝右动脉分支4例,脾动脉近脾门处1例,脾动脉中段1例。根据假性动脉瘤的部位和血流速度,选择合适的弹簧圈和Glubran-2胶浓度进行栓塞治疗。12例患者均栓塞成功,其中3例栓塞治疗后出现一过性胆红素增高,1例脾动脉瘤栓塞后脾脏部分梗死。结论:Glubran-2胶联合弹簧圈治疗外科术后内脏假性动脉瘤安全有效。根据血流动力学及血管情况配制合适的Glubran-2胶浓度,掌握注射速度,可提高栓塞成功率,减少异位栓塞的发生风险。

Objective:To evaluate the clinical efficacy and safety of glubran-2 glue in combination with coils used in the treatment of visceral artery pseudoaneurysms.Methods:DSA was performed in 12 patients with abdominal pseudoaneurysm after surgery and treated with glubran-2 glue in combination with coils.Clinical outcomes about therapeutic effect and complication were analyzed respectively.Results:Of the 12 patients with pseudoaneurysm,the location included gastroduodenal artery and its branches(n=4),branch of left hepatic artery(n=2),branch of right hepatic artery(n=4),splenic artery adjacent to splenic hilum(n=1)and the middle segment of splenic artery(n=1).According to the location and blood flow velocity of pseudoaneurysm,appropriate coils and concentration of glubron-2 glue were selected for transcatheter arterial embolization.All of the 12 patients were treated successfully with mild side effects including increase of bilirubin in a short period in 3 patients and partial splenic infarction in 1 patient.Conclusion:Transcatheter arterial embolization using glubran-2 glue in combination with coils is safe and effective in the treatment of abdominal pseudoaneurysm.Increase of the rate of successfulness and decrease of the risk of ectopic location of embolization could be obtained by using appropriate concentration of glubran-2 glue as well as the speed of injection.