彩色多普勒超声诊断股动脉假性动脉瘤及疗效监测

目的探讨彩色多普勒超声对股动脉假性动脉瘤诊断及监测治疗疗效的价值。方法经股动脉穿刺行冠状动脉介入术后发生股动脉假性动脉瘤23例,包括冠状动脉造影术后15例,冠状动脉支架置入术后8例,所有患者都用高频彩色多普勒超声诊断。在超声监控下,探头垂直加压压迫假性动脉瘤通道或破口直至内无血流通过。压迫失败后在超声引导下瘤腔内注射凝血酶,24h、1个月后复查超声。结果23例中有15例一次性压迫2h后假性动脉瘤瘤腔闭合;5例一次压迫2h后超声显示瘤腔明显变小,动脉与瘤腔仍有少许血流相通,再次压迫2h后瘤腔闭合;3例压迫2次失败后在超声引导下瘤腔内注射凝血酶,2例取得较满意的效果,1例经验不足失败。结论彩色多普勒超声诊断股动脉假性动脉瘤准确,简便,无创。且可在超声引导下行安全无创治疗。

Detecting and treatment monitoring of femoral artery pseudoaneurysm by color Doppler ultrasonography

Objective To evaluate the value of color Doppler flow imaging(CDFI)in the diagnosis of femoral pseudoaneurysm and treating with ultrasound-guided compression. Methods High frequency CDFI was performed on 23 cases with femoral pseudo aneurysm after coronary artery interventional therapy through femoral artery,including 15 cases after coronary arteriography and 8 cases after coronary stent implantation. CDFI monitored when the probe pressed the outlet of pseudo aneurysm vertically until no blood flow signal appeared. Prothrombin was injected into the antrum under the guidance of ultrasound when compression therapy failed. Repeat CDFI scan was performed after 24h and one month. Results Among 23 cases, the femoral pseudo aneurysm disappeared after pressing for 2h in 15 cases. The antrum of pseudo aneurysm diminished after pressing for 2h in 5 cases and disappeared after another 2h-compression. Three cases failed with compression therapy. We injected prothrombin into the antrum under the guidance of ultrasound. Satisfied results were achieved in 2 cases and one failed. Conclusion CDFI is accurate,safe and noninvasive in the diagnosis and treatment of femoral pseudoaneurysm.