腔内介入治疗锁骨下动脉外伤性假性动脉瘤
|
摘要
目的探讨腔内介入治疗锁骨下动脉外伤性假性动脉瘤的临床疗效。方法采用腔内介入方法治疗12例锁骨下动脉外伤性假性动脉瘤患者。3例假性动脉瘤位于左侧锁骨下动脉,9例位于右侧锁骨下动脉;2例位于锁骨下动脉第一段,各有5例位于第二段及第三段。结果腔内介入手术成功率100%,术后有1例患者4个月后出现内漏,再次行腔内介入手术后治愈。12例共置入覆膜支架14枚,术后随访期超过1年者锁骨下动脉均通畅,仅有2例发生轻度狭窄(<30%)。结论腔内介入治疗锁骨下动脉外伤性假性动脉瘤具有创伤小、成功率高、并发症少等优点,临床疗效令人满意。与外科手术相比优势明显,有望成为治疗锁骨下动脉外伤性假性动脉瘤的首选方法。
Objective To assess the clinical effect of endovascular interventional treatment for traumatic pseudoaneurysm( TPA) of subclavian artery. Methods Twelve patients with TPA of subclavian artery underwent endovascular interventional treatment. TPA on the left subclavian artery in 3 cases,on the right subclavian artery in 9 cases,on the first section of subclavian artery in 2 cases,on the second section in 5 cases and third section in 5 cases. Results All patients had achieved technical success. 1 case who occurred endoleak at 4 months after operation was be cured by the second endovascular interventional operation. Forteen stent-grafts had been implanted in 12 patients,the subclavian artery maintained patent in all patients follow-up over 1 year after operatiion,mild stenosis( < 30%) occurred only in 2 cases. Conclusion Endovascular interventional treatment for TPA of subclavain artery has many advantages,such as minor wound,high success rate,less complications and so on,the clinical outcome is satisfactory. It is expected to become the preferred method of treatment for TPA of subclavian artery.
Objective To assess the clinical effect of endovascular interventional treatment for traumatic pseudoaneurysm( TPA) of subclavian artery. Methods Twelve patients with TPA of subclavian artery underwent endovascular interventional treatment. TPA on the left subclavian artery in 3 cases,on the right subclavian artery in 9 cases,on the first section of subclavian artery in 2 cases,on the second section in 5 cases and third section in 5 cases. Results All patients had achieved technical success. 1 case who occurred endoleak at 4 months after operation was be cured by the second endovascular interventional operation. Forteen stent-grafts had been implanted in 12 patients,the subclavian artery maintained patent in all patients follow-up over 1 year after operatiion,mild stenosis( < 30%) occurred only in 2 cases. Conclusion Endovascular interventional treatment for TPA of subclavain artery has many advantages,such as minor wound,high success rate,less complications and so on,the clinical outcome is satisfactory. It is expected to become the preferred method of treatment for TPA of subclavian artery.
引文
1 苑超,汪忠镐,吴庆华,等.外科治疗锁骨下动脉瘤12例.中华外科杂志,2000,38:290
2 Schoder M,Cejna M,Holzenbein T,et al.Elective and emergent endovascular treatment of subclavian artery aneurysms and injuries.J Endovasc Ther,2003,10:58
3 Franz RW.Delayed treatment of a traumatic left subclavian artery pseudoaneurysm.Vasc Endovascular Surg,2008,42:482
4 Dubose JJ,Rajani R,Gilni R,et al.Endovascular management of axillo-subclavian arterial injury:a review of published experience.Injury,2012,43:1785
5 Soto JA,Munera F,Morales C,et al.Focal arterial injuries of the proximal extremities:helical CT arteriography as the initial method of diagnosis.Radiology,2001,218:188
6 Mansour MA,Gorsuch JM.Diagnosis and management of pseudoaneurysms.Perspect Vasc Surg Endovasc Ther,2007,19:58
7 Percutaneous ultrasound-guided thrombin injection of a post-traumatic pancreatic pseudoaneurysm in a peatric patient.Pediatr Surg Int,2012,28:95
8 Kumar RM,Reddy SS,Sharma R,et al.Endovascular repair of a traumatic axillary artery pseudoaneurysm.Cardiovasc Intervent Radiol,2009,32:598
9 Niinami H,Aomi S,Chikazawa G,et al.Progress in the treatment of aneurysms of the distal aortic arch:approach through median sternotomy.J Cardiovasc Surg,2003,44:243
10 Sitsen ME,Ho GH,Blankensteijn JD.Deformation of self-expanding stent-grafts complicating endovascular peripheral aneurysm repair.J Endovasc Surg,1999,6:288
11 Choke E,Thompson M.Endoleak after endovascular aneurysm repair:current concepts.J Cardiovasc Surg,2004,45:349
2 Schoder M,Cejna M,Holzenbein T,et al.Elective and emergent endovascular treatment of subclavian artery aneurysms and injuries.J Endovasc Ther,2003,10:58
3 Franz RW.Delayed treatment of a traumatic left subclavian artery pseudoaneurysm.Vasc Endovascular Surg,2008,42:482
4 Dubose JJ,Rajani R,Gilni R,et al.Endovascular management of axillo-subclavian arterial injury:a review of published experience.Injury,2012,43:1785
5 Soto JA,Munera F,Morales C,et al.Focal arterial injuries of the proximal extremities:helical CT arteriography as the initial method of diagnosis.Radiology,2001,218:188
6 Mansour MA,Gorsuch JM.Diagnosis and management of pseudoaneurysms.Perspect Vasc Surg Endovasc Ther,2007,19:58
7 Percutaneous ultrasound-guided thrombin injection of a post-traumatic pancreatic pseudoaneurysm in a peatric patient.Pediatr Surg Int,2012,28:95
8 Kumar RM,Reddy SS,Sharma R,et al.Endovascular repair of a traumatic axillary artery pseudoaneurysm.Cardiovasc Intervent Radiol,2009,32:598
9 Niinami H,Aomi S,Chikazawa G,et al.Progress in the treatment of aneurysms of the distal aortic arch:approach through median sternotomy.J Cardiovasc Surg,2003,44:243
10 Sitsen ME,Ho GH,Blankensteijn JD.Deformation of self-expanding stent-grafts complicating endovascular peripheral aneurysm repair.J Endovasc Surg,1999,6:288
11 Choke E,Thompson M.Endoleak after endovascular aneurysm repair:current concepts.J Cardiovasc Surg,2004,45:349