血管腔内治疗注射毒品所致股动脉假性动脉瘤破裂出血  

Endovascular treatment for ruptured femoral artery pseudoaneurysm associated with bleeding caused by injection of addictive drug

作　　者：李应龙[1] 何强[1] 顾福嘉[1] 庞尊中[1] 袁平[1] 潘扬[1] 

机构地区：[1]贵州省人民医院介入科,贵阳550002

出　　处：《介入放射学杂志》2017年第10期882-885,共4页Journal of Interventional Radiology

摘　　要：目的探讨血管腔内覆膜支架成形及弹簧圈栓塞治疗注射毒品所致股动脉假性动脉瘤(FAP)破裂出血的可行性、安全性、有效性。方法回顾性分析2012年7月至2015年12月收治的32例注射毒品所致FAP破裂出血患者临床资料。患者平均年龄36.5岁,其中男性25例(78.1%)。结果 32例患者均成功止血,血管腔内治疗技术成功率100%,围手术期无死亡患者。其中覆膜支架血管腔内修复术25例(78.1%),弹簧圈栓塞股深动脉3例(9.4%),覆膜支架+股深动脉栓塞4例(12.5%)。平均随访(17.5±11.6)个月,随访率93.8%(30/32),3年血管支架累积通畅率为90.9%,3年总体生存率为91.3%。结论血管腔内治疗注射毒品所致FAP破裂出血安全、快速,近中期疗效良好,为急危重症患者赢得二期外科清创修复时间,二期彻底清创是控制感染的重要手段。Objective To investigate the feasibility, safety and effectiveness of endovascular angioplasty with covered stent and embolization with spring coil in treating ruptured femoral artery pseudoancmysm （FAP） associated with bleeding caused by injection of addictive drug. Methods The clinical data of 32 patients with ruptured FAP complicated by bleeding caused by injection of addictive drug, who were admitted to authors＇ hospital during the period from July 2012 to December 2015, were retrospectively analyzed. The average age of the patients was 36.5 years old, among them 25 patients were male （78.1%）. Results Successful hemostasis was achieved in all 32 patients. The technical success rate of endovascular therapy was 100%, and no death occurred during perioperative period. Endovascular repair with covered stent was caM＇led out in 25 patients （78.1%）, embolization of femoral profound artery with spring coil in 9 patients （9.4%）, and covered stent implantation together with embolization of femoral profound artery in 4 patients （12.5%）. The patients were followed up tot a mean of （17.5＋11.6） months, with a follow-up rate being 93.8% （30/32）. The 3-year cumulative stent patency rate was 90.9%, and the 3-year overall survival rate was 91.3%. Conclusion For the treatment of ruptured FAP complicated by bleeding caused by injection of addictive drug, endovascular treatment is safe and effective with satisfactory mid-term clinical effect. This technique helps win the valuable time for critically ill patients to receive two-stage surgical debridement and vascular repair, as two-stage thorough debridement is an important means to control infection.

关 键 词：股动脉假性动脉瘤 注射吸毒 血管腔内成形术 弹簧圈栓塞术 

分 类 号：R654.4[医药卫生—外科学]