Onyx联合弹簧圈经导管栓塞脾动脉瘤

Transcatheter arterial embolization of splenic artery with Onyx and coils

目的探讨Onyx联合弹簧圈经导管栓塞脾动脉瘤的可行性及疗效。方法3例脾动脉瘤患者,其中中间型1例,远端型2例,均为真性动脉瘤。术中均先采用弹簧圈栓塞瘤体及载瘤动脉远端,后应用Onyx栓塞瘤体及载瘤动脉近端,其中1例应用球囊辅助栓塞。术后预防性应用抗生素3天,3天及1周复查血常规及血淀粉酶,1~3个月CT增强复查上腹部。结果3例成功栓塞,均出现不同程度的脾梗死,梗死面积10%~30%,1例出现术后低热,2例出现左上腹不同程度隐痛,症状于3~7天内缓解及消失,1例3天血淀粉酶不同程度升高,1周内恢复正常,术后随访CT未见瘤体破裂、复发。结论Onyx结合弹簧圈经导管栓塞脾动脉瘤可行、安全、有效。

Objective To investigate the feasibility and efficacy of Onyx combined with spring coil for embolization of splenic aneurysm through catheter.Methods There were 3 patients with true splenic aneurysm,including 1 patient with intermediate type and 2 patients with distal type.During the operation,the tumor body and the distal end of the parental artery were first embolized with spring coil,then the tumor body and the proximal end of the parental artery were embolized with Onyx embolization,and 3 cases were treated with balloon assisted embolization.Postoperative prophylactic antibiotics were used for 3 days,blood routine and blood amylase were reexamined at 3 days and 1 week,and enhanced upper abdominal CT was reexamined at 1 to 3 months.Results All 3 cases were successful embolization in varying degrees of splenic infarction,with infarct area by 10%~30%.One case presented with postoperative low thermal and 2 cases with different degrees of dull pain in the left upper abdomen.Symptom relifed and disappeared within 3~7 days.3 cases blood amylase increased in different degrees at 3 days,and backed to be normal within 1 week.No tumor rupture or recurrence was found in the follow-up CT.Conclusion Onyx combined with spring coil is feasible,safe and effective for embolization of splenic aneurysm.