介入治疗内脏动脉瘤的远期疗效

目的观察介入治疗内脏动脉瘤(VAA)的远期疗效。方法回顾性分析30例接受介入治疗VAA患者(41个瘤灶),术后随访时间均12个月,观察治疗效果及并发症。结果对12个肾动脉瘤、8个脾动脉瘤行动脉瘤填塞术,其中5个脾动脉瘤、5个肾动脉瘤采用裸支架辅助填塞;对13个脾动脉瘤、1个肝动脉瘤行动脉瘤栓塞术;对4个肾动脉瘤行载瘤动脉支架植入术,其中3个采用多层裸支架植入术、1个采用覆膜支架植入术;对2个肾动脉瘤、1个腹腔干动脉瘤行保守治疗;均获得成功。1个脾动脉瘤栓塞术后出现部分脾梗死,1个左肾多发动脉瘤植入支架后瘤腔小部分显影。术后随访12～55个月,平均(23.44±12.48)个月,期间脾梗死者梗死面积未增大、未见脓肿形成,瘤腔部分显影病变显影面积未增大。30例患者中,1例因心力衰竭死亡,余均存活,无VAA复发及其他并发症。结论介入治疗VAA远期疗效较好,且安全性较高。

Long-term effects of interventional treatments of visceral artery aneurysms

Objective To observe the long-term effects of interventional treatment of visceral artery aneurysms (VAA). Methods Data of 30 patients with 41 VAA received interventional therapies were retrospectively analyzed. The follow-up time after operations were more than 12 months, and the treatment effects and complications were observed. Results Aneurysm tamponade was performed for 12 renal aneurysms and 8 splenic aneurysms, including 5 renal aneurysms and 5 splenic aneurysms which underwent bare stent assistant tamponade. Embolization of aneurysm-bearing artery was performed for 13 splenic aneurysms and 1 hepatic aneurysm. Stent implantation of aneurysm-bearing artery was performed for 4 renal aneurysms, including 3 multilayer bare stent implantation and 1 coated stent implantation. Two renal aneurysms and 1 celiac trunk aneurysm received conservative treatment. The operations were all successful. Partial splenic infarction occurred in 1 splenic aneurysm after embolization, and a small part of the aneurysm cavity developed in 1 case with multiple left renal aneurysms after stent implantation. The postoperative follow-up time was 12 to 55 months, with an average of (23.44±12.48) months. During follow-up period, splenic infarction after operation did not increase, no abscess formatted, and the imaging area of part of the aneurysm cavity did not increase. One patient died of heart failure, and the rest were alive without recurrence and no other complications. Conclusion Interventional treatments of VAA had good long-term efficacy and high safety.