球囊辅助下凝血酶注射治疗自体动静脉内瘘相关肱动脉假性动脉瘤疗效观察及文献分析

Clinical observation of balloon-assisted thrombin injection in the treatment of AVF-related brachial artery PSA

目的探讨球囊辅助下凝血酶注射治疗自体动静脉内瘘(AVF)相关肱动脉假性动脉瘤(PSA)的有效性及安全性。方法回顾性分析我院2018年5月至2021年3月期间因AVF相关肱动脉PSA行DSA下球囊封堵联合超声引导下凝血酶注射(UGTI)治疗的患者资料,包括年龄、性别、原发病、动静脉内瘘位置及类型、血管吻合方式、穿刺部位、血管鞘大小、PSA超声特征(包括形状及大小、与皮肤的距离)、穿刺至UGTI的时间、球囊品牌及直径、抗凝方案、术后疗效及并发症情况(PSA内血栓化程度、瘤内活动性血流、动脉与PSA交通、动脉壁破口、远端动脉血栓、内瘘静脉血栓)等情况。结果经过上述治疗的患者均获得满意疗效,无明显并发症出现。结论球囊辅助下凝血酶注射治疗AVF相关肱动脉PSA是一种安全性好、疗效佳的治疗手段。

Objective To investigate the efficacy and safety of balloon-assisted thrombin injection in the treatment of brachial artery pseudoaneurysm(PSA)associated with autologous arteriovenous fistula(AVF).Methods From May 2018 to March 2021,the clinical data of all patients who underwent DSA balloon occlusion combined with ultrasound-guided thrombin injection(UGTI)because of AVF-related brachial artery PSA were analyzed retrospectively.We analyzed the patient's age,sex,primary disease,location and type of arteriovenous fistula,vascular anastomosis mode,puncture site,vascular sheath size,PSA ultrasound features(including shape and size,distance from skin),time from puncture to UGTI,balloon brand and diameter,anticoagulation regimen,postoperative efficacy and complications(degree of thromboembolization in PSA,intratumoral active blood flow,communication between artery and PSA,arterial wall rupture,distal arterial thrombosis,internal fistula venous thrombosis,etc).Results After the above treatment,all patients with AVF-related brachial artery PSA achieved satisfactory results,and there were no obvious complications.Conclusions Balloon-assisted thrombin injection is a safe and effective method for the treatment of AVF-related brachial artery PSA.