肱动脉入路在弓上异位支气管动脉介入栓塞术中的临床应用  

Clinical application of brachial artery approach in approacharch ectopic bronchial artery interventional embolization

作　　者：付志刚[1,2] 谭成红 李勋 谢迎春[1,2] 蔡非 张晓磷[1,2] FU Zhigang;TAN Chenghong;LI Xun;XIE Yingchun;CAI Fei;ZHANG Xiaolin(the First College of Clinical Medical Science,China Three Gorges University,Yichang,Hubei Province 443003,China;Department of Interventional Radiology,Yichang Central People's Hospital,Yichang,Hubei Province 443003,China;Department of Radiology,Chang yang People's Hospital,Chang yang,Hubei Province 443501,China;Department of Radiology,Dangyang People's Hospital,Dangyang,Hubei Province 444100,China)

机构地区：[1]三峡大学第一临床医学院,湖北宜昌443003 [2]宜昌市中心人民医院介入放射科,湖北宜昌443003 [3]长阳县人民医院放射科,湖北长阳443501 [4]当阳市人民医院放射科,湖北当阳444100

出　　处：《实用放射学杂志》2022年第8期1351-1354,共4页Journal of Practical Radiology

摘　　要：目的探讨肱动脉入路在弓上异位支气管动脉(AEBA)介入栓塞术中的可行性及安全性.方法连续选取大咯血患者341例,术前均行CT支气管成像(CTBA)检查,常规右股动脉入路,选择性或超选择性行责任支气管动脉的数字减影血管造影(DSA)和栓塞术,AEBA插管失败后选择患侧肱动脉入路完成手术.分析AEBA影像学表现,评估肱动脉入路的技术成功率、临床成功率及并发症.结果本研究中技术成功率95.0%(324/341),临床成功率92.9%(317/341).共发现异位支气管动脉(EBA)43例,占12.6%(43/341),其中AEBA 13例,占3.8%(13/341).13例AEBA中,7例股动脉入路插管失败,占53.8%(7/13),后采用患侧肱动脉入路成功栓塞.技术成功率100%(13/13),临床成功率100%(13/13).术后1例出现肱动脉穿刺点周围血肿,自行吸收好转,无其他严重并发症发生.结论AEBA采用肱动脉入路插管是安全可行的,止血疗效肯定.Objective To investigate the feasibility and safety of brachial artery approach in approacharch ectopic bronchial artery(AEBA)interventional embolization.Methods A total of 341 patients with massive hemoptysis were collected continuously.All patients underwent CT bronchial angiography(CTBA)examination before surgery,as well as selective or superselective digital subtraction angiography(DSA)and embolization of the responsible bronchial artery were performed via conventional right femoral artery approach.The brachial artery approach on the affected side would be selected to complete the surgery once AEBA intubation failed.AEBA imaging features were analyzed,while the technical success rate,clinical success rate and complications of brachial artery approach were evaluated.Results The technical success rate was 95.0%(324/341)and the clinical success rate was 92.9%(317/341).43 ectopic bronchial arteries(EBA)were found[12.6%(43/341)],13 of which were AEBA[3.8%(13/341)].Of the 13 AEBA cases,7(53.8%)failed to be intubated by femoral artery approach(7/13).Subsequently,brachial artery approach on the affected side was successfully embolic.The technical success rate was 100%(13/13),and the clinical success rate was 100%(13/13).Postoperative hematoma around the puncture point of brachial artery occurred in 1 case,which was improved by self-absorption without other serious complications.Conclusion Brachial artery approach intubation is safe and feasible for AEBA,and hemostasis is effective.

关 键 词：肱动脉入路 弓上异位支气管动脉 介入治疗 

分 类 号：R562[医药卫生—呼吸系统] R815[医药卫生—内科学]