创伤性假性动脉瘤的腔内介入治疗  

Endovascular treatment of traumatic pseudoaneurysm

作　　者：张希全[1] 葛世堂 齐德明 陈众[1] 潘晓琳[1] 

机构地区：[1]解放军第148医院介入血管科全军腔内介入诊疗中心,山东淄博255300 [2]齐鲁医药学院医学影像系,山东淄博255200

出　　处：《中国血管外科杂志（电子版）》2017年第3期183-186,共4页Chinese Journal of Vascular Surgery(Electronic Version)

基　　金：军队后勤科研计划重点基金项目(CJN14J010)

摘　　要：目的探讨创伤性假性动脉瘤(TPA)血管腔内治疗方法及疗效。方法回顾性分析2009年6月至2016年7月解放军第148医院收治的28例TPA患者临床资料,其中TPA位于四肢动脉13例,颈内动脉2例,肾动脉5例,胆囊动脉2例,臀上动脉2例,髂总动脉1例,肠系膜上动脉1例,脾动脉1例,阴茎动脉1例。17例主干型假性动脉瘤采用覆膜支架腔内隔绝术或多层裸支架植入术,11例终末型假性动脉瘤采用弹簧圈栓塞术。结果 28例患者腔内介入治疗均取得成功,假性动脉瘤均消失。17例植入支架者术后远端动脉搏动正常,无重要分支动脉闭塞,11例弹簧圈栓塞者术后出血停止,未出现脏器缺血坏死。术后随访6~39个月,平均(18.9±10.7)个月,失访1例,所有随访患者假性动脉瘤未复发,支架植入患者血管通畅,未发现支架移位、断裂,弹簧圈异位等并发症。结论根据假性动脉瘤位置、类型和侧支循环等选择不同的介入方法治疗TPA,具有微创操作简单、手术成功率高、并发症少、疗效确切的优点,可作为TPA的一线治疗方法。Objective To explore the treatment and efficacy of the endovascular treatment of traumatic pseudoaneurysm（TPA）. Methods From June 2009 to July 2016, a total of 28 patients with TPA were admitted to the Department of Interventional Vascular, the 148 th Hospital of Chinese People ＇s Liberation Army. The clinical data were retrospective analyzed. The lesions were located at the limb artery（n=13）,internal carotid artery（n =2）, renal artery（n =5）, cystic artery（n =2）, superior gluteal artery（n =2）, common iliac artery（n=1）, superior mesenteric artery（n=1）, splenic artery（n=1） and penile artery（n=1）. Endovascular stent graft or multilayer bare stents were used to isolate the type of pseudoaneurysm in 17 cases, metallic coils embolization was employed in 11 cases with terminal type of pseudoaneurysm. Results The procedure was successful in all patients, aneurysm cavities disappeared in all patients of pseudoaneurysm. Distal arterial pulse returned to normal and no important branch arteries occlusion occurred in 17 cases of stent implantation,no ischemic necrosis of organ occurred in 11 cases of metallic coils embolization. 27 cases were followed up for 6~39 months（mean, 18.9 ±10.7 months）, with 1 case lost to follow-up, and the false aneurysm did not recur, the artery remained patency in patients of stent implantation. During the follow-up period, no coils migration, stent displacement or stent fracture, etc. were found. Conclusion Based on the locations, types and collateral pathways of pseudoaneurysm, different individualized treatment shoud be adopted for TPA is technically simple and micro-invasive, higher technical success rate and good clinical outcome with a low incidence of complications. Therefore, this technique can be used as a first-line therapy option for TPA.

关 键 词：创伤性假性动脉瘤 支架 介入治疗 

分 类 号：R654.4[医药卫生—外科学]