可解脱带纤维毛弹簧圈栓塞系统治疗内脏动脉瘤的疗效分析
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摘要
目的探讨应用可解脱带纤维毛弹簧圈栓塞系统治疗内脏动脉瘤的安全性和有效性。方法选择2015年10月~2017年10月在解放军总医院血管外科收治的内脏动脉瘤患者33例,男性12例,女性21例,平均年龄(63.8±3.5)岁。应用可解脱带纤维毛弹簧圈栓塞系统结合普通弹簧圈进行动脉瘤腔内栓塞治疗。脾动脉瘤20例(60.6%),肾动脉瘤7例(21.2%),肠系膜上动脉瘤3例(9.1%),腹腔干动脉瘤2例(6.1%),胰十二指肠下动脉瘤1例(3.0%)。瘤体直径16~38(24.0±3.4)mm,迷走脾动脉合并脾动脉瘤7例。统计技术成功率、相关并发症及操作时间。术后3、6、12个月及每年行超声或CT随访检查。结果所有患者技术成功率为100%,术中无出血及异位栓塞并发症,1例合并脾动脉夹层,未处理。随访2~24(12.5±2.3)个月,随访期间无内脏动脉瘤增大及破裂,无治疗相关严重并发症或死亡。结论可解脱带纤维毛弹簧圈栓塞系统结合普通弹簧圈治疗内脏动脉瘤安全有效,近中期结果满意。
Objective To study the safety and efficacy of detachable fibered coils occlusion system for visceral artery aneurysms.Methods Thirty-three visceral artery aneurysms patients(12 males and 21 females)with an average age of 63.8±3.5 years who underwent endovascular embolization with detachable fibered coils occlusion system combined with standard pushable coils in our hospital were included in this study.Of these patients,20(60.6%),7(21.2%),3(9.1%),2(6.1%),and 1(3.0%)were respectively diagnosed with splenic artery aneurysm,renal aneurysm,superior mesenteric aneurysm,celiac aneurysm,and pancreaticoduodenal aneurysm.The mean diameter of aneurysms was 16-38(24.0±3.4)mm.The success rate of detachable fibered coils occlusion system for visceral artery aneurysms,postoperative complications and surgical procedure time were recorded.The patients received CT or ultrasonographic follow-up at months 3,6,12 and every year after operation.Results The success rate of detachable fibered coils occlusion system for visceral artery aneurysms was 100%.No intraoperative bleeding and coil migration occurred.One patient with splenic artery dissection did not undergo operation.The patients were followed up for 2-24(12.5±2.3)months,during which no enlargement or rupture of visceral artery aneurysms and no operation-related severe complication or death occurred.Conclusion Detachable fibered coils occlusion system combined with standard pushable coils is safe and effective for mild and moderate visceral artery aneurysms.
Objective To study the safety and efficacy of detachable fibered coils occlusion system for visceral artery aneurysms.Methods Thirty-three visceral artery aneurysms patients(12 males and 21 females)with an average age of 63.8±3.5 years who underwent endovascular embolization with detachable fibered coils occlusion system combined with standard pushable coils in our hospital were included in this study.Of these patients,20(60.6%),7(21.2%),3(9.1%),2(6.1%),and 1(3.0%)were respectively diagnosed with splenic artery aneurysm,renal aneurysm,superior mesenteric aneurysm,celiac aneurysm,and pancreaticoduodenal aneurysm.The mean diameter of aneurysms was 16-38(24.0±3.4)mm.The success rate of detachable fibered coils occlusion system for visceral artery aneurysms,postoperative complications and surgical procedure time were recorded.The patients received CT or ultrasonographic follow-up at months 3,6,12 and every year after operation.Results The success rate of detachable fibered coils occlusion system for visceral artery aneurysms was 100%.No intraoperative bleeding and coil migration occurred.One patient with splenic artery dissection did not undergo operation.The patients were followed up for 2-24(12.5±2.3)months,during which no enlargement or rupture of visceral artery aneurysms and no operation-related severe complication or death occurred.Conclusion Detachable fibered coils occlusion system combined with standard pushable coils is safe and effective for mild and moderate visceral artery aneurysms.
引文
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[6]Hemp JH,Sabri SS.Endovascular management of visceral arterial aneurysms[J].Tech Vasc Interv Radiol,2015,18(1):14-23.DOI:10.1053/j.tvir.2014.12.003.
[7]Dudeck O,Bulla K,Wieners G,et al.Embolization of the gastroduodenal artery before selective internal radiotherapy:a prospectively randomized trial comparing standard pushable coils with fibered interlock detachable coils[J].Cardiovasc Intervent Radiol,2011,34(1):74-80.DOI:10.1007/s00270-010-9845-7.
[2]Jesinger RA,Thoreson AA,Lamba R.Abdominal and pelvic aneurysms and pseudoaneurysms:imaging review with clinical,radiologic,and treatment correlation[J].Radiographics,2013,33(3):E71-E96.DOI:10.1148/rg.333115036.
[3]Venturini M,Marra P,Colombo M,et al.Endovascular treatment of visceral artery aneurysms and pseudoaneurysms in 100patients:covered stenting vs transcatheter embolization[J].J Endovasc Ther,2017,24(5):709-717.DOI:10.1177/1526602817717715.
[4]Chin JA,Heib A,Ochoa Chaar CI,et al.Trends and outcomes in endovascular and open surgical treatment of visceral aneurysms[J].J Vasc Surg,2017,66(1):195-201.DOI:10.1016/j.jvs.2017.02.036.
[5]Cochennec F,Riga CV,Allaire E,et al.Contemporary management of splanchnic and renal artery aneurysms:results of endovascular compared with open surgery from two European vascular centers[J].Eur J Vasc Endovasc Surg,2011,42(3):340-346.DOI:10.1016/j.ejvs.2011.04.033.
[6]Hemp JH,Sabri SS.Endovascular management of visceral arterial aneurysms[J].Tech Vasc Interv Radiol,2015,18(1):14-23.DOI:10.1053/j.tvir.2014.12.003.
[7]Dudeck O,Bulla K,Wieners G,et al.Embolization of the gastroduodenal artery before selective internal radiotherapy:a prospectively randomized trial comparing standard pushable coils with fibered interlock detachable coils[J].Cardiovasc Intervent Radiol,2011,34(1):74-80.DOI:10.1007/s00270-010-9845-7.