经远端桡动脉入路血管内弹簧圈介入栓塞治疗脾动脉瘤的效果

Study on the effect of endovascular spring coil interventional embolization in the treatment of splenic artery aneurysm through the distal radial artery approach

目的分析经远端桡动脉入路血管内弹簧圈介入栓塞治疗脾动脉瘤的临床效果。方法回顾性分析2021年12月至2023年12月于西安市第三医院接受血管内弹簧圈介入栓塞治疗的56例脾动脉瘤患者临床资料。按照手术入路将患者分为两组,采取经解剖鼻烟壶区远端桡动脉入路的25例患者为远端桡动脉组,采取经股动脉入路的31例患者为股动脉组。远端桡动脉组男15例,女10例,年龄(55.2±8.5)岁,瘤体长径(3.9±1.3)cm;股动脉组男17例,女14例,年龄(54.4±8.3)岁,瘤体长径(3.7±1.2)cm。比较两组患者的手术情况、并发症发生率及术后随访结果。采用独立样本t检验、χ^(2)检验、Fisher确切概率法进行统计学分析。结果远端桡动脉组的穿刺时间[(5.6±1.1)min比(5.1±1.0)min]、X射线照射时间[(12.1±3.2)min比(10.7±3.0)min]及手术时间[(57.6±15.4)min比(50.8±14.1)min]均长于股动脉组(均P<0.05),但术后无需卧床;远端桡动脉组和股动脉组的穿刺成功率及手术成功率比较,差异均无统计学意义(均P>0.05)。远端桡动脉组并发症总发生率低于股动脉组[12.0%(3/25)比35.5%(11/31)](P<0.05)。随访期间两组均未见弹簧圈移位、异位栓塞、瘤体再通、复发及死亡等。结论经远端桡动脉入路血管内弹簧圈介入栓塞治疗脾动脉瘤是安全、可行的,虽围手术期的操作时间略长,但术后无需卧床,住院时间较短,有利于患者术后康复,同时降低了并发症发生率,安全性更高。

Objective To investigate the clinical effect of endovascular spring coil interventional embolization in the treatment of splenic artery aneurysm through the distal radial artery approach.Methods The clinical data of 56 patients with splenic artery aneurysm who received endovascular coil interventional embolization in Xi'an Third Hospital from December 2021 to December 2023 were retrospectively analyzed.The patients were divided into two groups according to the different surgical approaches:25 patients who took the distal radial artery approach through the anatomical snuff bottle area were classified as a distal radial artery group,and 31 patients who took the femoral artery approach were classified as a femoral artery group.In the distal radial artery group,there were 15 males and 10 females,aged(55.2±8.5)years,with a tumor diameter of(3.9±1.3)cm.In the femoral artery group,there were 17 males and 14 females,aged(54.4±8.3)years,with a tumor diameter of(3.7±1.2)cm.The operation status,complication rate,and postoperative follow-up results were compared between the two groups.Independent sample t test,χ^(2) test,and Fisher exact probability method were used for statistical analysis.Results The puncture time[(5.6±1.1)min vs.(5.1±1.0)min],X-ray irradiation time[(12.1±3.2)min vs.(10.7±3.0)min],and operation time[(57.6±15.4)min vs.(50.8±14.1)min]in the distal radial artery group were all longer than those in the femoral artery group(all P<0.05),but no need to stay in bed after surgery.There was no statistically significant difference in the success rate of puncture or operation between the distal radial artery group and the femoral artery group(both P>0.05).The total incidence of complications in the distal radial artery group was lower than that in the femoral artery group[12.0%(3/25)vs.35.5%(11/31)](P<0.05).No spring coil displacement,ectopic embolism,tumor recalculation,recurrence or death were observed in both groups during follow-up.Conclusions It is safe and feasible to embolize the splenic artery aneurysm through the distal radial artery approach.Although the operation time during perioperative period is slightly longer,there is no need to stay in bed after operation,and it can effectively shorten the postoperative hospitalization time,which is more conducive to the patients'postoperative recovery.