经导管选择性动脉栓塞治疗创伤性假性动脉瘤

目的探讨经导管选择性动脉栓塞治疗损伤性假性动脉瘤的疗效。方法 16例损伤性出血患者,其中肾脏出血5例,肝脏出血3例,剖宫产后出血4例,切口妊娠流产1例,宫颈癌放疗后出血1例,骨外伤术后出血2例。采用经股动脉穿刺选择性插管进行靶动脉造影及栓塞治疗。采用明胶海绵和（或）弹簧钢圈栓塞瘤腔及供血动脉。结果全部患者动脉造影均见假性动脉瘤,其中2例伴有动静脉瘘。栓塞成功率100%,栓塞后即刻造影示假性动脉瘤消失,止血成功率93.75%。术后均未发生严重并发症,随防6个月均无复发。结论经导管选择性动脉栓塞治疗损伤性假性动脉瘤性出血安全有效、创伤小、并发症少,是可靠的治疗方法 。

Treatment for traumatic pseudoaneurysms via selective transcatheter arterial embolization

Objective To discuss the effect on traumatic pseudoaneurysm (PA) treated with selective transcatheter arterial embolization. Methods Sixteen patients with trauma-hemorrhage, including 5 patients with renal hemorrhage, 3 with hepatic hemorrhage, 4 with postpartum hemorrhage, 1 with caesarean scar pregnancy, 1 with uterine cervix cancer after radiotherapy and 2 with osteal hemorrhage were diagnosed and treated. Transcatheter selective arterial embolization was performed after angiography in all patients and gelatin sponge articles and coils were used as embolus. Results All 16 patients with PA were diagnosed correctly through selective angiography. Angiography showed 2 patients with arteriovenous fistula. The successful rate was 100%. After selective embolization, the aneurysmal sac showed no filling on the digital subtraction angiography (DSA) image. The arresting bleeding successful rate was 93.75%. No procedure-related complications occurred. All the patients remained bleeding symptom free during a follow-up of 6 months. Conclusion Transcatheter selective arterial embolization is a safe, effective and reliable alternative for the treatment of PA with little trauma and relative few complications.