血管腔内介入治疗肾动脉瘤的临床疗效分析  

Clinical efficacy analysis of endovascular intervention for renal artery aneurysm

作　　者：徐啸阳 张帅[1] 仲斌演 沈健[1] 朱晓黎[1] Xiaoyang Xu;Shuai Zhang;Binyan Zhong;Jian Shen;Xiaoli Zhu(Department of Interventional Radiology,the First Affiliated Hospital of Soochow University,Jiangsu Suzhou 215000,China)

机构地区：[1]苏州大学附属第一医院介入科,江苏苏州215000

出　　处：《中华介入放射学电子杂志》2024年第2期137-143,共7页Chinese Journal of Interventional Radiology：electronic edition

基　　金：江苏省科技厅重点研发计划(社会发展)(BE2021648);江苏省自然科学基金面上项目(SBK2023022210)。

摘　　要：目的探讨腔内治疗肾动脉瘤(renal artery aneurysm,RAA)的临床疗效及诊治体会。方法回顾性分析2016年3月至2023年2月苏州大学附属第一医院收治的14例采用腔内治疗的RAA患者手术资料和临床结果。记录术前与术后临床表现、影像学资料、肾功能变化以及术中与术后并发症的发生情况。结果14例患者中Ⅰ型RAA有2例,瘤体位于肾动脉主干;Ⅱ型RAA有7例,瘤体位于肾动脉分叉处;Ⅲ型RAA有5例,瘤体起源于肾内血管。瘤体平均最大径为11~57 mm,平均(21.8±11.4)mm;基底宽度为4.0~15.0 mm,平均(6.9±2.7)mm;载瘤动脉直径为1.8~5.1 mm,平均(3.9±1.0)mm。14例RAA患者均成功行腔内介入治疗,采用瘤腔栓塞12例,覆膜支架置入1例,载瘤动脉栓塞1例,手术成功率100%。腰腹痛患者术后症状缓解5例,高血压患者术后血压降至正常5例。术后平均随访时间为(20.1±18.4)个月,随访期间动脉瘤无复发,无严重并发症发生。结论腔内治疗RAA安全有效,弹簧圈栓塞可联合支架置入、球囊等手段治疗更为复杂的病例。Objective To investigate the clinical efficacy and diagnosis and treatment experience of endovascular treatment for renal artery aneurysm(RAA).Methods Retrospective analysis of surgical data and clinical outcomes of 14 patients with RAA treated with endovascular intervention admitted to the First Hospital of Soochow University from 03,2016 to 02,2023.The preoperative and postoperative clinical manifestations,imaging manifestations,renal function,and the occurrence of intraoperative and postoperative complications were recorded.Results Among the 14 patients,there were 2 cases of typeⅠRAA,in which the aneurysm were located in the main trunk of the renal artery;7 cases of typeⅡRAA,in which the aneurysm was located in the bifurcation of the renal artery;5 cases of typeⅢRAA,in which the aneurysm originated from the intrarenal vessels.The mean maximum diameter of the aneurysms was(21.8±11.4)mm(11~57 mm),the mean basal width was(6.9±2.7)mm(4.0~15.0 mm),and the mean diameter of the aneurysm-carrying artery was(3.9±1.0)mm(1.8~5.1 mm).All 14 patients with RAA were successfully treated with endovascular intervention,using embolization of the aneurysm in 12 cases,covered stent placement in 1 case,and embolization of the aneurysm-carrying artery in 1 case,and the success rate was 100%.Five patients with lumbar and abdominal pain had relief of symptoms,and five patients with hypertension had their blood pressure reduced to normal after endoluminal intervention.There was no recurrence of aneurysm and no serious complications during the follow-up period which was with a mean of(20.1±18.4)months.Conclusion Endovascular intervention for RAA is safe and effective.Spring-coil embolization can be combined with stent-graft and balloon to treat more complex cases.

关 键 词：肾动脉瘤 弹簧圈栓塞 支架置入 介入治疗 

分 类 号：R737.11[医药卫生—肿瘤]