单中心支架辅助弹簧圈栓塞治疗肾动脉瘤的疗效分析

Single-center stent assisted coil embolization in treatment of renal aneurysms

目的探讨支架辅助栓塞术(SAE)治疗宽基底型肾动脉瘤(RAA)患者的安全性和中远期疗效。方法收集2011年2月至2019年5月于海军军医大学第一附属医院(上海长海医院)行SAE治疗的90例RAA患者的临床资料。观察患者的肾动脉瘤形态参数、肾小球滤过率(GFR)等临床资料,并对患者进行术后随访,了解患者术后生存、并发症等情况。结果90例患者共有116个RAA瘤体。手术成功率为100%,围手术期间无死亡病例。13例患者出现并发症,其中发生主要围手术期并发症者3例,发生次要并发症者10例。围手术期未发生多脏器功能衰竭、急性心肌梗死等并发症。90例均获得1、12、24个月的随访,随访率100%。90例患者中,1例患者在术后1个月出现肾功能不全,2例患者分别在术后3、4个月时出现肾功能衰竭,2例患者在术后1个月检查时发现穿刺点假性动脉瘤,3例患者在术后12个月时复查出现肾动脉支架再狭窄。结论SAE可以安全、有效地治疗宽基底RAA或位于肾动脉分支动脉的RAA患者,技术成功率高,具有良好的中远期结果。

Objective To investigate the safety and long-term efficacy of stent-assisted embolization(SAE)for patients with wide base renal aneurysm(RAA).Method Clinical data of 90 RAA patients treated with SAE in the First Affiliated Hospital of Naval Military Medical University from February 2011 to May 2019 was collected.The morphological parameters of renal aneurysms,glomerular filtration rate(GFR)and other clinical data of the patients were observed,and the patients were followed up for postoperative survival and complications.Result There were 116 RAA tumors in 90 patients.The success rate of operation was 100%,and there was no death during perioperative period.A total of 13 patients experienced complications,of which 3 experienced primary complications and 10 the secondary.No complications such as multiple organ failure and acute myocardial infarction occurred during perioperative period.All 90 cases were followed up for 1,12 and 24 months,and the follow-up rate was 100%.Among the 90 patients,1 patient developed renal insufficiency 1 month after surgery,2 patients developed renal failure 3 and 4 months after surgery,respectively,pseudoaneurysm at the puncture site was observed in 2 patients during examination 1 month after surgery,and renal artery stent restenosis was observed in 3 patients during reexamination 12 months after surgery.Conclusion SAE can safely and effectively treat patients with wide base RAA or RAA located in the branch of the renal artery,with a high technical success rate and good long-term results.