目的 探讨血管内栓塞术治疗内脏和外周假性动脉瘤的应用价值.方法 回顾性分析37例假性动脉瘤的血管内栓塞治疗前后的临床资料,3 ～ 36个月随访期内观察栓塞疗效及术后并发症等.结果 37例患者DSA造影发现41枚假性动脉瘤,其中来源于内脏动脉26例,臀上、臀下动脉5例,颈外动脉分支4例,肢体动脉2例.36例患者成功栓塞40枚假瘤,其中明胶海绵栓塞7枚,PVA颗粒栓塞9枚,弹簧圈栓塞11枚,弹簧圈辅以明胶海绵或PVA栓塞13枚.随访期内36例患者中34例出血停止,假瘤完全闭塞,有2枚假瘤复发,术后无严重并发症发生.结论 血管内栓塞术治疗假性动脉瘤安全、有效,假性动脉瘤的性质和栓塞材料的选择在一定程度上会影响疗效.%Objective To discuss the clinical value of transcatheter endovascular arterial embolization in treating visceral and peripheral pseudoaneurysms. Methods A total of 37 patients with visceral or peripheral pseudoaneurysms were treated with endovascular arterial embolization. The clinical data were retrospectively analyzed. All the patients were followed-up for 3-36 months. The clinical effectiveness were evaluated and the postoperative complications were analyzed. Results Digital subtraction angiography demonstrated 41 pseudoaneurysms in 37 patients, which originated from the visceral arteries (n = 26), from the superior or inferior gluteal arteries (n = 5), from the external carotid branches (n = 4) or from limb arteries (n = 2). Successful embolization was accomplished for 40 pseudoaneurysms in 36 patients. Gelfoam was used in 7 cases, PVA particles in 9 cases, steel coils in 11 cases and steel coils together with Gelfoam or PVA particles in 13 cases. During the follow-up period, hemorrhage ceased in 34 patients, and the pseudoaneurysms were completely obstructed. Recurrence of pseudoaneurysm was seen in two cases. No severe complications occurred after the treatment. Conclusion Transcatheter endovascular arterial embolization is a safe and effective technique for the treatment of visceral and peripheral pseudoaneurysms. The pathologic nature of the pseudoaneurysm as well as the materials used for embolization may influence the clinical effect to a certain degree.(J Intervent Radiol, 2013, 22: 060-063)
展开▼
