介入诊疗相关医源性股动脉假性动脉瘤危险因素及治疗分析  

Risk factors for intervention-related iatrogenic femoral artery pseudoaneurysm and its treatment

作　　者：周亚东[1] 官云彪[1] 薛明[1] 郑学洵 陈幸生[1] ZHOU Yadong;GUAN Yunbiao;XUE Ming;ZHENG Xuexun;CHEN Xingsheng(Department of Vascular Surgery,Affiliated Union Hospital of Fujian Medical University,Fuzhou,Fujian Province 350001,China)

机构地区：[1]福建医科大学附属协和医院血管外科,福州350001

出　　处：《介入放射学杂志》2022年第3期243-246,共4页Journal of Interventional Radiology

摘　　要：目的探讨经股动脉入路介入诊疗过程中发生医源性股动脉假性动脉瘤(IFPA)的危险因素。方法回顾性分析2015年1月至2019年12月在福建医科大学附属协和医院就诊并接受经股动脉穿刺入路手术患者临床和影像学资料,统计分析术后IFPA发生及治疗情况。结果纳入经股动脉穿刺介入诊疗患者1605例,其中42例(2.61%)术后发生IFPA。多元logistic回归分析结果显示,年龄>65岁(OR=5.17,95%CI=1.92~13.93)、女性(OR=14.72,95%CI=6.06~35.78)、吸烟史(OR=20.90,95%CI=5.89~74.12)和置管溶栓(OR=6.25,95%CI=2.51~15.55)是IPFA发生的独立预测因子,使用血管闭合装置(OR=0.03,95%CI=0.004~0.22)是IFPA发生的保护因素。42例IFPA患者中40例经超声定位手动按压破口治愈,2例通过覆膜支架腔内隔绝治疗。结论高龄、女性、有吸烟史及置管溶栓治疗患者经股动入路介入诊疗术后发生IFPA风险较高,应密切关注,早诊断早处理。采用血管闭合装置联合手动压迫可有效减少IFPA发生。Objective To explore the risk factors for iatrogenic femoral pseudoaneurysm(IFPA) caused by interventional procedures via femoral approach,and to briefly analyze its treatment results.Methods The clinical data and imaging materials of the patients,who received interventional therapy via the femoral artery puncturing route at the Affiliated Union Hospital of Fujian Medical University of China between January 2015 and December 2019,were retrospectively collected.The occurrence of postoperative IFPA and its treatment results were analyzed.Results A total of 1605 patients were enrolled in this study,among them42(2.61%)developed IFPA.Multivariate logistic regression analysis showed that>65 years(OR=5.17,95%CI=1.92-13.93),female(OR=14.72,95%CI=6.06-35.78),smoking history(OR=20.90,95%CI=5.89-74.12),and catheter-directed thrombolysis(OR=6.25,95%CI=2.51-15.55)were the independent predictors for the occurrence of IFPA,while the use of a vascular closure device(OR=0.03,95%CI=0.004-0.22)was a protective factor for the occurrence of IFPA.Of the 42 IFPA patients,40 were cured by manual compression on the artery rupture site under ultrasound guidance and 2 received endovascular isolation treatment with covered stent implantation.Conclusion In these patients,who are aged,female,having a history of smoking and receiving catheter-directed thrombolysis,the risk of occurring postoperative IFPA is very high,and to them close attention should be paid.Once IFPA occurs,the diagnosis and treatment should be made as early as possible.The use of vascular closure device combined with manual compression can effectively reduce the occurrence of IFPA.(J Intervent Radiol,2022,31:243-246)

关 键 词：假性动脉瘤 股动脉 危险因素 治疗 

分 类 号：R654[医药卫生—外科学]