创伤性假性动脉瘤的介入治疗

Interventional therapy of traumatic pseudoaneurysm

目的 介绍不同类型创伤性假性动脉瘤 (假瘤 )的几种不同治疗方法。方法 8例不同部位、不同创伤原因引起的的假瘤 ,采用不同的方法进行治疗。 3例终末型动脉的假瘤采用明胶海绵栓塞 ,2例主干性外周动脉的假瘤采用覆膜支架置入术将其隔绝 ,1例支干型假瘤采用两端弹簧圈栓塞 ,1例股动脉穿孔型假瘤采用压迫法 ,另 1例巨大血肿伴假瘤经栓塞后作手术血肿清除加动脉结扎术进行治疗。结果 所有假瘤均完全闭合 ,置入覆膜支架者其远端动脉搏动正常。 1例患者因其他原因 ,致穿刺部位又出现假瘤。其他患者无并发症。结论 采用不同的介入技术能治疗各种假瘤 。

Objective To introduce the different therapeutic methods for the different types of traumatic pseudoaneurysms. Methods Traumatic pseudoaneurysm was treated in 8 patients. Intraarterial embolization was performed with gelfoam in 3 patients for terminal type. Endovascular covered stent graft was inserted in 2 patients with trunk type. One patient with branch type, we used metallic coils to embolize both broken ends. One patient with perforation in femoral artery was treated with compression. For 1 patient with huge haematoma and pseudoaneurysm, operation for elimination the haematoma was performed after embolization. Results Pseudo- aneurysm kept closed after treatment achieved in all 8 patients. Distal arterial pulse was normal in 2 patients treated with stent graft. A new pseudoaneurysm presented as a complication at puncture site in 1 patient due to other factors. There were no other symptomatic complications. Conclusions Pseudo- aneurysms can be treated effectively with interventional techniques instead of surgical operation.