超选择载瘤动脉栓塞术治疗腹腔非主干动脉假性动脉瘤破裂出血

目的探讨超选择载瘤动脉栓塞术治疗腹腔非主干动脉假性动脉瘤破裂出血的临床疗效及安全性。 方法回顾性分析2017年2月至2020年6月采用超选择栓塞治疗的腹腔内非主干动脉假性动脉瘤破裂出血患者临床资料,分析止血效果及并发症,总结治疗经验。 结果21例患者均使用微导管超选择至假性动脉瘤的载瘤动脉以微弹簧圈行栓塞治疗,其中10例联合明胶海绵颗粒进行巩固栓塞。21例患者中18例患者栓塞假性动脉瘤的载瘤动脉近端血管,3例患者于假性动脉瘤载瘤动脉的远端和近端行"三明治"栓塞,技术成功率100%（21/21）,初次栓塞的临床成功率81.0%（17/21）,二次栓塞后总体临床成功率为85.7%（18/21）。4例患者术后有一过性轻度腹痛,1例患者发生脾脏部分梗死,予对症抗炎治疗后好转。 结论超选择载瘤动脉栓塞术治疗腹腔非主干动脉假性动脉瘤破裂出血成功率高、可重复性强,是一种可供选择的治疗方法。合理选择栓塞材料可达到较好的止血效果并降低并发症的发生。

Superselective parent artery embolization for the treatment of ruptured-abdominal pseudoaneurysm on branched artery

ObjectiveTo investigate the clinical efficacy and safety of superselective parent artery embolization in the treatment of ruptured-abdominal pseudoaneurysm on branched artery. MethodsThe clinical data of patients with ruptured-abdominal pseudoaneurysm on branched artery treated by superselective parent artery embolization from February 2017 to June 2020 were retrospectively analyzed. The hemostatic effect and complications were analyzed, and the clinical experience was summarized. ResultsAll the21 patients received superselective parent artery embolization with micro-coils. Among them, 10 patients were embolized with gelfoam particles additionally for consolidated embolization. 18 patients were embolized at the proximal part of the parent artery and 3 patients were treated with "sandwich" embolization technique. The technical success rate was 100% (21/21). The clinical success rate of primary embolization was 81.0% (17/21), and the overall clinical success rate after secondary embolization was 85.7% (18/21). Transient mild abdominal pain was observed in 4 patients and partial splenic infarction occurred in 1 patient after embolization. All the sympotoms relieved after treatment. ConclusionsSuperselective parent artery embolization is of high success rate and easy to repeat. It is an alternative treatment for ruptured-abdominal pseudoaneurysm on branched artery. Reasonable selection of embolic materials can achieve better hemostasis effect and reduce the incidence of complications.