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目的 探讨高流入性阴茎异常勃起的病因与发病机制,提高其诊断和治疗水平。方法 分析总结2例外伤后动脉性高流入性阴茎异常勃起病人的临床资料。2例均经多功能彩色多谱勒检查确诊。其中1例行选择性阴部内动脉造影,并用明胶海绵行右侧海绵体动脉栓塞术。结果 本组2例患者中,行超选择性海绵体动脉栓塞术治疗的病例术后阴茎变软,术后随访阴茎勃起功能恢复正常;另1例仅行海绵体穿刺放血后向海绵体内注入阿拉明治疗,阴茎暂时变软,很快又恢复至原来状态,治疗效果不佳。结论 阴茎海绵体血气分析及选择性阴部内动脉造影是诊断海绵体动脉窦状隙瘘的主要依据。超选择性海绵体动脉栓塞术治疗动脉性高流入性阴茎异常勃起是安全而有效的方法。 相似文献
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微钢圈对急性出血性疾病的栓塞治疗作用 总被引:15,自引:1,他引:14
目的 评价微导管—微钢圈系统在治疗急性出血性疾病中的作用。方法 对12例患有急性出血性疾病的患者施行了急诊血管造影及栓塞治疗。患者包括十二指肠出血4例,空肠出血2例,肝脏出血2例,肾脏出血2例,膀胱出血1例,阴茎外伤性持续勃起1例。所有病例均使用微导管系统进行供血血管的超选择插管,并使用微钢圈进行栓塞治疗。6例患者在使用微钢圈之前首先用明胶海绵颗粒进行栓塞。使用微钢圈数1—5个(平均2.1个)。结果 所有患者均达到完全止血的目的。单纯明胶海绵颗粒栓塞往往难以达到完全止血的目的。其中1例小肠出血的年轻患者在栓塞止血后行手术治疗以彻底解除病因。其他患者在随访期间(1周至10个月,平均4个月)均无再出血。未见明显与栓塞治疗直接相关的合并症发生。结论 应用微导管/微钢圈系统对急性出血性疾病进行治疗,其栓塞效果好且副作用小,值得在临床上大力推广。 相似文献
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目的 探讨超选择性动脉栓塞在医源性损伤导致的肾出血中的应用价值.方法 2009年12月至2012年2月收治11例医源性损伤导致的肾出血患者,其中肾造瘘术后出血3例,经皮肾镜取石术术后出血3例,肾肿瘤部分性肾切除术后出血3例,钬激光术后2例.采用超选择方法将导管置于出血动脉,用聚乙烯醇颗粒及弹簧圈或(和)微弹簧圈栓塞治疗.结果 所有患者均一次性成功进行出血动脉栓塞治疗,造影过程中可见动静脉瘘,对比剂外溢、滞留及假性动脉瘤形成.所有患者在栓塞治疗后出血症状均消失,未观察到明显的肾功能损害,临床随访4 ~ 35个月未再发生出血.结论 超选择性动脉栓塞是治疗医源性肾出血的有效、安全的方法,值得在临床推广应用. 相似文献
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经血管内栓塞治疗颈外动脉—海绵窦瘘 总被引:2,自引:0,他引:2
目的:探讨经血管内栓塞治疗3例颈外动脉海绵窦瘘的临床意义。材料和方法:3例颈外动脉海棉窦瘘均经股动脉入路栓塞,采用微螺旋圈和聚乙烯醇颗粒将瘘口闭塞。结果:术后患者临床症状显著改善。随访1个月至1年病情无复发。结论:颅内无血管杂音是其重要体征。将微导管置入瘘口是栓塞成功的关键 相似文献
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我们从1992年5月始采用阴茎背深静脉结扎术治疗静脉漏性阳萎8例,效果满意,报告如下。临床资料1.一般情况年龄23~49岁,平均30.5岁,阳萎时间3个月~3年.平均1年6个月。病史中无高血压、糖尿病、外伤及遗传病史、第二性征及生殖器发育正常。肛门检查:球海绵体肌反应和括约肌张力均正常。2临床表现8例病人大部分有夜间或晨起阴茎胀大,但均难行房事。有2例病人勃起不坚并有早泄,查体阴茎背动脉均可扪及,有1例病人双侧精索静脉曲张。3.罂粟碱试验本组病人均做了罂粟碱试验,海绵体内注射罂粟碱30~60mg后观察阴茎勃起情况,注药后勃… 相似文献
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选择性动脉插管栓塞治疗子宫大出血的价值 总被引:4,自引:0,他引:4
目的 评价选择性动脉插管栓塞治疗子宫大出血的临床应用价值.资料与方法 对64例子宫大出血患者均行双侧髂总动脉数字减影血管造影(DSA)检查,明确出血部位后选择或超选择插管,栓塞子宫动脉或髂内动脉前干,栓塞剂采用明胶海绵、聚乙烯醇(PVA)微粒、弹簧钢圈.结果 64例患者行DSA检查时,盆腔区均可见对比剂外溢和聚集,其中36例采用明胶海绵颗粒栓塞子宫动脉或髂内动脉前干后31例止血一次成功,其中5例7~10天再发大出血,行第二次介入栓塞治疗后3例止血成功,仅2例止血效果不佳而行子宫切除术;20例采用PVA微粒和明胶海绵颗粒栓塞以及3例合并有动静脉瘘和2例合并有假性动脉瘤者采用明胶海绵条加弹簧钢圈后止血一次成功;3例采用PVA微粒和明胶海绵颗粒仅栓塞一侧子宫动脉或髂内动脉前干后3~7天再发出血,行第二次介人栓塞对侧子宫动脉或髂内动脉前干止血成功.介入术后随访2~6个月无复发,均有正常月经来潮,无严重并发症发生.结论 动脉栓塞治疗子宫大出血安全、止血迅速、微创,绝大多数能避免手术切除子宫. 相似文献
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PURPOSE: To retrospectively evaluate the long-term results of transcatheter arterial embolization for high-flow priapism. MATERIAL AND METHODS: The study comprised six patients with high-flow priapism treated by superselective embolization of the internal pudendal arteries at our institution. The cause of priapism was traumatic in five patients and idiopathic in one. Follow-up was > or = 5 years in all cases. RESULTS: A total of nine embolizations were performed in the six patients. Embolization was performed once in three patients, while repeated embolizations were performed in the remaining three. Eleven arteries were altogether treated. Embolic materials used were gelatin sponge in nine arteries, gelatin sponge and microcoils in one, and microcoils alone in one. Embolization of the internal pudendal arteries on both sides in one single session was performed in one patient. In one patient, complete occlusion of the pseudoaneurysm was not achieved. However, restoration of erectile function and detumescence were noted during follow-up. Complications during the procedure were not registered. At follow-up > or = 5 years after successful embolization, all six patients experienced detumescence as well as normal erectile function. CONCLUSION: Superselective embolization of the internal pudendal artery is the procedure of choice for treatment of high-flow priapism. 相似文献
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Treatment of “High-Flow” Priapism with Superselective Transcatheter Embolization: A Useful Alternative to Surgery 总被引:2,自引:0,他引:2
O'Sullivan P Browne R McEniff N Lee MJ 《Cardiovascular and interventional radiology》2006,29(2):198-201
Purpose To review the efficacy of treatment of high-flow priapism with superselective transcatheter embolization.
Methods Over a 2-year period, we reviewed five patients who were treated for traumatic high-flow priapism with superselective embolization.
All patients underwent diagnostic angiography that demonstrated a communication between the cavernosal artery and the corpora
cavernosa. Each identified fistula was embolized using gel-foam, blood clot, microcoils, or a combination of these.
Results All five patients had successful detumesence of priapism postprocedure. There was normal recurrence of early morning erection
with successful detumescence for each patient within a 2- to 4-week period. Two of five patients (40%) presented with recurrence
of priapism at 6 months and required a repeat embolization procedure. At 1 year, four of the five patients (80%) had normal
erectile function.
Conclusion Superselective transcatheter embolization is a useful therapeutic modality in the treatment of high-flow priapism. It provides
equivalent rates of detumesence when compared to surgical techniques, and appears to have a greater success in preserving
erectile function. 相似文献
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Kim KR Shin JH Song HY Ko GY Yoon HK Sung KB Ahn TY Kim CW Kim YH Ko HK Kwak BK Shim HJ Chung HH Shin SW Bae JI 《Journal of vascular and interventional radiology : JVIR》2007,18(10):1222-1226
PURPOSE: To evaluate the effectiveness and safety of treatment of high-flow priapism (HFP) with superselective transcatheter embolization at nine university hospitals. MATERIALS AND METHODS: Between May 1994 and October 2006, 27 patients underwent superselective embolization of the cavernous artery for HFP. Trauma was apparent in 22 patients, there was self-administered intracavernosal injection for erectile dysfunction in two, and the remaining three did not recall any penile or perineal trauma. The embolic agents used were autologous blood clot (n = 12), gelatin sponge (n = 12), microcoils combined with gelatin sponge (n = 1), polyvinyl alcohol (n = 1), and N-butyl cyanoacrylate (n = 1). Recurrence of priapism and change in erectile function were evaluated during a mean follow-up of 13 months. Differences in results between patients treated with autologous blood clot versus gelatin sponge were statistically analyzed with use of the chi(2) test. RESULTS: In 24 of 27 patients (89%), a single embolization was sufficient for complete resolution of priapism. Repeat embolization was required in two patients (7%), and in the remaining patient (4%), shunt surgery was performed after embolization as a result of HFP coexisting with corporeal venoocclusive dysfunction. Eighteen of 23 patients (78%) who had premorbid normal erectile function showed maintained potency during the follow-up period. There was no significant difference affecting required repeat embolization (P = .537) and change in quality of erection (P = .615) during the follow-up period between the autologous blood clot and gelatin sponge treatment groups. CONCLUSIONS: Superselective transcatheter embolization in the treatment of HFP is effective and ensures a high level of preservation of premorbid erectile function. 相似文献
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Superselective embolization with coils in high-flow priapism 总被引:4,自引:0,他引:4
Kress O Heidenreich A Klose KJ Wagner HJ Alfke H 《Cardiovascular and interventional radiology》2002,25(4):326-329
Priapism can be divided into "low-flow"
veno-occlusive priapism and, especially in children, rare
"high-flow" arterial priapism. We report a 5-year-old boy who
developed arterial priapism after blunt perineal trauma that was
successfully treated by superselective embolization with microcoils. 相似文献
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目的:探讨经微导管置放微钢圈栓塞治疗经皮肾镜取石术(PCNL)后难止性肾出血的方法和效果。方法:回顾性分析2006~2011年接受PCNL治疗后难止性肾出血13例,采用股动脉插管,行肾动脉造影明确出血动脉后,以微导管行超选择性出血动脉内释放微钢圈栓塞治疗。结果:13例患者栓塞后48 h内肉眼血尿消失,所有病例随访6~12个月肾出血无复发,尿素氮、血肌酐正常,无治疗并发症。结论:肾动脉造影和经微导管超选择性出血动脉内释放微钢圈栓塞治疗PCNL术后难止性出血,创伤小、见效快,可最大限度保护肾功能,应作为首选治疗方法。 相似文献
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Gandini R Spinelli A Konda D Reale CA Fabiano S Pipitone V Simonetti G 《Cardiovascular and interventional radiology》2004,27(5):544-548
Two patients with posttraumatic priapism underwent transcatheter embolization using microcoils, resulting in temporary penile detumescence and an apparent resolution of the artero-venous fistula. In both cases, priapism recurred 24 hours after the procedure and was successfully treated through selective transcatheter embolization of the nidus using acrylic glue (Glubran 2). The patients showed complete recovery of sexual activity within 30 days from the procedure and persistent exclusion of the artero-venous fistula after a 12-month follow-up. 相似文献
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Hiroyuki Tokue Kei Shibuya Hiroyuki Ueno Azusa Tokue Yoshito Tsushima 《Cardiovascular and interventional radiology》2016,39(9):1343-1346
There are many treatment options in high-flow priapism. Those mentioned most often are watchful waiting, Doppler-guided compression, endovascular highly selective embolization, and surgery. We present a case of high-flow priapism in a 57-year-old man treated by percutaneous direct puncture embolization of a post-traumatic left cavernosal arteriovenous fistula using N-butyl-cyanoacrylate. Erectile function was preserved during a 12-month follow-up. No patients with percutaneous direct puncture embolization for high-flow priapism have been reported previously. Percutaneous direct puncture embolization is a potentially useful and safe method for management of high-flow priapism. 相似文献
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Embolization of renal vascular lesions: Clinical experience with microcoils and tracker catheters 总被引:2,自引:0,他引:2
Peter E. Huppert M.D. Stephan H. Duda Cristiane M. Erley Martin Roth Werner Lauchart Klaus Dietz Claus D. Claussen 《Cardiovascular and interventional radiology》1993,16(6):361-367
After biopsy (n=6) and nephrostomy (n=1) of three native and four transplanted kidneys, gross hematuria, hypertension, and
deterioration of function necessitated performance of transarterial embolization. Angiography revealed five arteriovenous
fistulas (AVFs), one pseudoaneurysm, and one arteriocaliceal fistula. Superselective catheterization was accomplished using
5 Fr standard diagnostic catheters and 3 Fr coaxial Tracker catheters. Four of five AVFs were embolized successfully by inserting
unfibered (2 patients) and fibered (2 patients) platinum coils (diameters 2 mm and 4 mm, respectively). For one AVF, additional
injection of butylcyanoacrylate was necessary. The pseudoaneurysm was embolized successfully by such injection, and the arteriocaliceal
fistula was occluded using one unfibered 2-mm coil. Embolization stopped the bleeding in all patients. One week after treatment,
renal function was improved in 5 patients and remained unaffected in 2. Superselective embolization using Tracker catheters
and fibered microcoils is an effective, safe treatment of renal vascular lesions. 相似文献
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