创伤性腋动脉损伤的腔内修复治疗  

Endovascular repair of traumatic axillary artery injury

作　　者：张希全[1] 葛世堂 

机构地区：[1]解放军第148医院全军腔内介入诊疗中心,山东淄博255300

出　　处：《中国临床医学影像杂志》2017年第9期657-659,664,共4页Journal of China Clinic Medical Imaging

基　　金：军队后勤科研计划资助项目(CJN14J010)

摘　　要：目的:探讨腔内血管修复技术治疗创伤性腋动脉损伤的可行性及其疗效。资料与方法:回顾性分析2008年2月—2016年8月14例接受血管腔内治疗的创伤性腋动脉损伤患者资料,血管造影表现为对比剂外溢、假性动脉瘤和血管狭窄/闭塞。对比剂外溢和假性动脉瘤行覆膜支架治疗,对血管狭窄、闭塞行血管成形术或裸支架治疗。结果:14例患者手术均获成功,平均手术时间为45 min(30~80 min),其中置入覆膜支架、裸支架各6例,单纯球囊扩张2例。腔内治疗后腋动脉血流恢复通畅,无对比剂外溢,无严重并发症发生。随访14例,2~36月(平均19.5月),1例患者因支架内血栓形成给予溶栓治疗后血流恢复通畅,其余患者上肢动脉血流保持通畅。结论:腔内治疗创伤性腋动脉损伤,能快速修复损伤血管,恢复肢体血流,临床疗效满意,具有创伤小、操作简单等优点,是一种安全、有效的方法。Objective： To explore the feasibility and efficacy of endovascular repair for traumatic axillary artery injury. Methods： The clinical data of 14 patients with traumatic axillary artery injury undergoing endovascular intervention from February 2008 to August 2016 were retrospectively analyzed, the angiography showed that contrast extravasation, pseudoaneurysms, vascular stenosis or occlusion. Contrast extravasation and pseudoaneurysms were treated with stent grafts, vascular stenosis or occlusion were treated with bare stents or angioplasty. Results： Operation was performed successfully in all 14 patients, The mean operation time was 45 minutes（30～80 minutes）. The interventions included balloon angioplasty（n=2）, covered stent implantation（n=6） and bare stent implantation（n=6）. After endoluminal treatment, axillary artery blood flow recovered, no contrast extravasation or severe complications occurred. Fourteen patients were followed up for 2~36 months（mean of 19.5 months）, one stent-graft occlusion occurred, which was treated with intraarterial pharmacologic thrombolysis, blood flow patency was kept in the rest of the upper limb artery. Conclusion： For traumatic axillary artery injury, percutaneous interventional treatment can rapidly repair vascular injury and restore the blood flow, the clinical effect is significant, with less invasive performance and easy to operate, and it is a safe and effective method.

关 键 词：腋动脉 创伤和损伤 血管成形术 气囊 

分 类 号：R654.3[医药卫生—外科学] R815[医药卫生—临床医学]