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1.
Management of Splenic Artery Aneurysms and False Aneurysms with
Endovascular Treatment in 12 Patients 总被引:9,自引:4,他引:5
Guillon R Garcier JM Abergel A Mofid R Garcia V Chahid T Ravel A Pezet D Boyer L 《Cardiovascular and interventional radiology》2003,26(3):256-260
Purpose: To assess the endovascular
treatment of splenic artery aneurysms and false aneurysms.
Methods: Twelve patients (mean age 59 years, range 47–75
years) with splenic artery aneurysm (n = 10) or false
aneurysm (n = 2) were treated. The lesion was
asymptomatic in 11 patients; hemobilia was observed in one patient. The
lesion was juxta-ostial in one case, located on the intermediate
segment of the splenic artery in four, near the splenic hilus in six,
and affected the whole length of the artery in one patient. In 10
cases, the maximum lesion diameter was greater than 2 cm; in one case
30% growth of an aneurysm 18 mm in diameter had occurred in 6 months;
in the last case, two distal aneurysms were associated (17 and 18 mm in
diameter). In one case, stent-grafting was attempted; one detachable
balloon occlusion was performed; the 10 other patients were treated
with coils.
Results: Endovascular treatment was possible
in 11 patients (92%) (one failure: stenting attempt). In four cases
among 11, the initial treatment was not successful (residual perfusion
of aneurysm); surgical treatment was carried out in one case, and a
second embolization in two. Thus in nine cases (75%) endovascular
treatment was successful: complete and persistent exclusion of the
aneurysm but with spleen perfusion persisting at the end of follow-up
on CT scans (mean 13 months). An early and transient elevation of
pancreatic enzymes was observed in four cases.
Conclusion: Ultrasound and CT have made the diagnosis of
splenic artery aneurysm or false aneurysm more frequent. Endovascular
treatment, the morbidity of which is low, is effective and spares the
spleen. 相似文献
2.
Jean-Paul Beregi Alain Prat Serge Willoteaux Marc-Antoine Vasseur Valérie Boularand Frédéric Desmoucelle 《Cardiovascular and interventional radiology》1999,22(1):13-19
Purpose: To evaluate initial and midterm results of percutaneous treatment of peripheral aneurysms using covered stents.
Methods: Between June 1994 and December 1997 we used covered stents (EndoPro System or Passager) on 19 patients with peripheral aneurysms
(7 iliac, 5 subclavian, 3 femoral, 3 popliteal, 1 carotid).
Results: Successful aneurysm exclusion was achieved in 18 of 19 patients (95%). In the short term (<30 days), one patient died of
puncture site hemorrhage complicated by myocardial infarction; two femoral stents were surgically removed because of leakage.
At subsequent follow-up (mean 20 months) two further unrelated deaths occurred. At 1 year (intention-to-treat) the stent was
patent in 13 of 19 patients (68%) and the aneurysm was excluded in 17 of 19 (89%).
Conclusion: Treatment of peripheral aneurysms with covered stents has a high rate of immediate procedural success. Continued exclusion
of the aneurysms is achieved in a large proportion of patients but there is a relatively high rate of stent thrombosis. 相似文献
3.
In a retrospective study 344 CT examinations of patients with suspected aneurysms of the abdominal aorta were evaluated with respect to the inflammatory character of the aneurysm. In 207 cases surgical therapy was conducted. In 144 of those 207 cases preoperative ultrasound examination results were also available. Frequency of inflammatory aneurysms, as classified by CT, was 10.2% (35/344) and in the subgroup of surgically treated aneurysms, 14.0% (29/207). Sensitivity and specifity of CT to realise the inflammatory type of aneurysm was 86.2% and 97.2%. The respective figures for ultrasound examinations on the basis of 144 surgically treated aneurysms were 26.1% and 100%. We conclude that even in cases of sonographically unequivocal abdominal aneurysms CT should be performed because ultrasound is not sufficiently sensitive to realise an inflammatory character of the aneurysm, which can have great impact on surgical strategy.
Correspondence to: E. Rinast 相似文献
4.
Gould DA Edwards RD McWilliams RG Rowlands PC Martin J White D Fear S Bakran A Brennan J Gilling-Smith G Harris PL 《Cardiovascular and interventional radiology》2000,23(5):358-363
Purpose: To investigate the incidence, significance, and mechanism of stent-graft distortion after endovascular repair (EVR) of abdominal
aortic aneurysm.
Methods: EVR of abdominal aortic aneurysm was performed in 51 cases (49 modular, bifurcated; 2 tube). Thirty-two patients were followed
for 6 or more months and had equivalent baseline and follow-up images which could be used to determine changes in graft configuration.
Sac dimensions were measured using computed tomographic (CT) images and graft-related complications were recorded.
Results: Amongst 32 patients evaluated on follow-up, there was graft distortion in 24. Distorted grafts were significantly (p= 0.002) associated with sac diameter reduction (mean 5 mm) and sac length reduction (mean 8.1 mm). All graft-related complications
occurred in the limbs of eight distorted grafts, with a mean reduction of sac length in this group of 7.8 mm on reformatted
CT images.
Conclusion: There was a highly significant association between graft distortion and limb complications, and reduced sac dimensions. 相似文献
5.
Wei Chiang Liu Byung Kook Kwak Kyo Nam Kim Soon Yong Kim Joung Joo Woo Dong Jin Chung Ju Hee Hong Ho Sung Kim Chang Jun Lee Hyung Jin Shim 《Korean journal of radiology》2000,1(4):215-218
Tuberculous aneurysm of the aorta is exceedingly rare. To date, the standard therapy for mycotic aneurysm of the abdominal aorta has been surgery involving in-situ graft placement or extra-anatomic bypass surgery followed by effective anti-tuberculous medication. Only recently has the use of a stent graft in the treatment of tuberculous aortic aneurysm been described in the literature. We report two cases in which a tuberculous aneurysm of the abdominal aorta was successfully repaired using endovascular stent grafts. One case involved is a 42-year-old woman with a large suprarenal abdominal aortic aneurysm and a right psoas abscess, and the other, a 41-year-old man in whom an abdominal aortic aneurysm ruptured during surgical drainage of a psoas abscess. 相似文献
6.
Sixty femoral pseudoaneurysms were identified by colour Doppler flow imaging over a period of 27 months. One group (n = 42) was treated immediately by ultrasound-guided compression repair (UGCR). In the remaining 18 pseduaneurysms a conservative theraphy attempt, which was successful in 9 patients within 1 week, preceded UGCR. Unsuccessful conservative theraphy did not prejudice the feasibility and outcome of UGCR. the success rate (50 of 51 UGCR) was higher than that reported in the literature, but was at the expense of a longer compression time.Multiple parameters were correlated with the compression time. A significant correlation was found with the size of the perfused lumen in the pseudoaneurysm and with the diameter, lenght and shape of the aneurysm neck. Follow-up at 24 h and 1 week after UGCR revealed 1 thrombotic complication and 4 partial recurrences. Within 1 week there was a significant decrease in the size of the (then thrombosed) pseudoaneurysms.
Correspondence to: A. Tschammler 相似文献
7.
The endovascular treatment of cerebral aneurysms with coils poses significant technical challenges, particularly with respect to wide-necked aneurysms. We present the results of our initial experiences in using a stent for endovascular treatment of aneurysms, with an emphasis on potential applications, technical aspects, and associated complications. Twenty-three wide-necked aneurysms from 22 patients were treated during the 13-month study period. Seven patients presented with subarachnoid hemorrhage. Aneurysms were located at the internal carotid artery (n=14), the vertebral artery (n=3), the basilar artery (n=5), and the middle cerebral artery (n=1). A Neuroform stent2 was used for stent-assisted procedures. Premedication with antithrombotic agents was available for unruptured cases. Postprocedural antithrombotic medication was prescribed for all patients. Nineteen aneurysms were primarily stented, followed by coil placement. For five of these aneurysms, stenting was performed subsequent to failure of an attempt to frame with an initial coil. Stenting for the remaining four aneurysms was performed as a rescue procedure to prevent the migration of previously placed coils. Complete occlusion was obtained in ten aneurysms, nearly complete occlusion (95% or more occluded) in 11 aneurysms, and partial occlusion (less than 95% occluded) in one aneurysm. In one aneurysm, we failed to navigate the microcatheter into the aneurysmal sac through the interstices of the stent. Stent thrombosis was noted during the procedure in one patient. Hemorrhagic complication on the 25th day after the procedure was noted in one patient. No procedure-related complications were observed during the procedure or during follow-up in the remaining 20 patients, including seven patients who did not receive antithrombotic agents prior to endovascular treatment owing to recent subarachnoid hemorrhage. To overcome the technical limitation in the coiling of wide-necked aneurysms, stent-assisted coil embolization may be a technically feasible and relatively safe method, even though longer periods of follow-up are required. 相似文献
8.
Percutaneous Ablation of Peripheral Pseudoaneurysms Using Thrombin: A Simple and Effective Solution 总被引:8,自引:0,他引:8
Owen RJ Haslam PJ Elliott ST Rose JD Loose HW 《Cardiovascular and interventional radiology》2000,23(6):441-446
Purpose: To assess the effectiveness of tissue adhesive and thrombin solution in the percutaneous ablation of peripheral artery pseudoaneurysms.
Methods: Twenty-five pseudoaneurysms were treated over a 33-month period; all had failed ultrasound-guided compression. Tissue adhesive
or thrombin solution was injected percutaneously, with needle tip position and changes within the aneurysm confirmed with
color Doppler ultrasound. In 19 cases we utilized a protective balloon inflated across the aneurysm neck prior to the injection
of tissue adhesive and in six cases used thrombin injection alone. Seven patients were anticoagulated. Patients were followed
up after the procedure.
Results: All 25 aneurysms were treated successfully; two patients required a return visit and there were no immediate complications
or peripheral emboli detected. One patient developed a contralateral pseudoaneurysm.
Conclusions: The percutaneous injection of pseudoaneurysms is a safe, atraumatic, and effective treatment for femoral artery pseudoaneurysms
in the peripheral circulation. There are significant advantages over ultrasound-guided compression or surgical repair. 相似文献
9.
Kadirvel R Ding YH Dai D Lewis DA Kallmes DF 《Journal of vascular and interventional radiology : JVIR》2011,22(10):1447-1451
Purpose
Intracranial saccular aneurysms are associated with chronic remodeling of the arterial wall. The pathobiology of aneurysm growth and rupture is poorly understood. The present study was performed to study the gene expression patterns in elastase-induced saccular aneurysms in rabbits 5 years after aneurysm creation, compared with unoperated control arteries.Materials and Methods
Elastase-induced saccular aneurysms were created in 25 rabbits and followed up for 5 years. Thirteen rabbits died during follow-up for reasons unrelated to the aneurysms. RNA was isolated from aneurysm tissue and the control contralateral common carotid artery in five of the 12 surviving animals, and analyzed for gene expression by using human gene microarrays. Genes with statistical differences between groups (P < .05 and fold change ≥ 1.5 and ≤ 0.75) were considered differentially expressed. Real-time polymerase chain reaction (RT-PCR) was used for confirmation of gene microarray findings for selected genes.Results
Fifty-three of 13,353 genes (0.4%) were differentially expressed in the aneurysms compared with the unoperated control arteries. Molecular and functional pathway analysis revealed that immunoregulatory molecules, growth factors, cell adhesion molecules, and structural molecules were differentially expressed in the aneurysms compared with controls. RT-PCR results of selected genes confirmed the differential expression identified by using the gene chip microarray.Conclusions
Significant modulation in a variety of biochemical and cellular functions in chronic aneurysms provides molecular insights into the pathophysiology of saccular aneurysms. 相似文献10.
Müller-Hülsbeck S Link J Schwarzenberg H Walluscheck KP Heller M 《Cardiovascular and interventional radiology》1999,22(2):96-102
Purpose: To determine the efficacy of percutaneous endoluminal stents and stent-grafts for the treatment of isolated femorpopliteal
aneurysms.
Methods: Seven men (age 51–69 years) with femorpopliteal occlusions (n=6) related to aneurysms and a patent femoropopliteal aneurysm (n=1) were treated percutaneously. In two patients uncovered Wallstents and in five patients polyestercovered nitinol stents
were implanted. Assessment was performed with Doppler ultrasound and duplex ultrasonography 24 hr, 1, 3, 6, 12, and 24 months
after the intervention. Additionally, intraarterial angiography was performed at 6 months.
Results: Stent placement succeeded in all cases. No immediate adjunctive surgical treatment was necessary. Ankle-brachial index (ABI)
improved from 0.29±0.29 (SD) before to 0.78±0.23 (SD) 24 hr after the intervention. One patient was lost to follow-up. Stent-graft
occlusion occurred in four patients: after 2 days (n=1), 1 month (n=2), and 3 months (n=1). One of the patients, whose stent occluded at 1 month, underwent successful recanalization with local fibrinolysis therapy.
Three of the seven, all with three-vessel run-off, demonstrated patency of the stent, which was assessed by duplex ultrasonography
at 29, 31, and 34 months. Breaking of the stent struts or significant stent migration was not observed.
Conclusions: These results in a small number of patients warrant further investigation to evaluate the role of percutaneous stents in
femoropopliteal aneurysms. Until further data of clinical studies are available, this method cannot be recommended, and it
cannot replace surgical treatment. 相似文献
11.
Summary Three cases illustrating the moyamoya phenomenon and an aneurysm in the periphery of the lateral ventricle in angiograms are reported. The mechanism of occurrence of an aneurysm in the Moyamoya phenomenon is discussed. 相似文献
12.
Michael B. Pitton Tobias Scheschkowski Markus Ring Sascha Herber Katja Oberholzer Annegret Leicher-Düber Achim Neufang Walther Schmiedt Christoph Düber 《Cardiovascular and interventional radiology》2009,32(5):906-917
The purpose of this study was to evaluate the clinical results, complications, and secondary interventions during long-term
follow-up after endovascular aneurysm repair (EVAR) and to investigate the impact of endoleak sizes on aneurysm shrinkage.
From 1997 to March 2007, 127 patients (12 female, 115 male; age, 73.0 ± 7.2 years) with abdominal aortic aneurysms were treated
with Talent stent-grafts. Follow-up included clinical visits, contrast-enhanced MDCT, and radiographs at 3, 6, and 12 months
and then annually. Results were analyzed with respect to clinical outcome, secondary interventions, endoleak rate and management,
and change in aneurysm size. There was no need for primary conversion surgery. Thirty-day mortality was 1.6% (two myocardial
infarctions). Procedure-related morbidity was 2.4% (paraplegia, partial infarction of one kidney, and inguinal bleeding requiring
surgery). Mean follow-up was 47.7 ± 34.2 months (range, 0–123 months). Thirty-nine patients died during follow-up; three of
the deaths were related to aneurysm (aneurysm rupture due to endoleak, n = 1; secondary surgical reintervention n = 2). During follow-up, a total of 29 secondary procedures were performed in 19 patients, including 14 percutaneous procedures
(10 patients) and 15 surgical procedures (12 patients), including 4 cases with late conversion to open aortic repair (stent-graft
infection, n = 1; migration, endoleak, or endotension, n = 3). Overall mean survival was 84.5 ± 4.7 months. Mean survival and freedom from any event was 66.7 ± 4.5 months. MRI depicted
significantly more endoleaks compared to MDCT (23.5% vs. 14.3%; P < 0.01). Patients in whom all aneurysm side branches were occluded prior to stent-grafting showed a significantly reduced incidence
of large endoleaks. Endoleaks >10% of the aneurysm area were associated with reduced aneurysm shrinkage compared to no endoleaks
or <10% endoleaks (Δ at 3 years, −1.8% vs. −12.0%; P < 0.05). In conclusion, endovascular aneurysm treatment with Talent stent-grafts demonstrated encouraging long-term results
with moderate secondary intervention rates. Primary occlusion of all aortic side branches reduced the incidence of large endoleaks.
Large endoleaks significantly impaired aneurysm shrinkage, whereas small endoleaks did not. 相似文献
13.
Vallée JN Pierot L Mont'alverne F Turjman F Bonafé A Bracard S Lo D Crozier S Duffau H Barragan-Campos HM Jean B Guillevin R Chiras J 《Neuroradiology》2005,47(6):438-445
Our purpose was to evaluate the postoperative aneurysm occlusion volume and clinical results of treating unruptured intracranial aneurysm using three-dimensional (3D) coils. Over a 2-year period 62 aneurysms (39 with a neck 4 mm, 23 with a neck >4 mm) in 62 patients in five participating centres were treated. The procedure consisted, firstly, of framing the aneurysm with one or more spherical 3D coils, and secondly, of filling it with two-dimensional (2D) helical coils. Anatomical and clinical results were evaluated by univariate analysis. Multivariate analysis was used to identify independent predictors of these results. For neck sizes 4 and >4 mm, angiographic occlusion was complete in 31 (79%) and 16 (70%) aneurysms, respectively; the mean percentage of occlusion volume was 31.4% and 29.5%, respectively, and postoperative morbidity was 3% and 4%, respectively, with no significant differences between the two groups. There were no deaths. However, occlusion volume correlated with sac size (P=0.037) and sac-to-neck ratio <1.5 (P=0.073), except when three or more 3D coils per aneurysm were used (P=0.516 and P=0.308, respectively). Occlusion volume correlated with the number of 3D coils per aneurysm (P<0.001) and was an independent predictor of angiographic complete occlusion (P=0.002). The use of the largest number of 3D coils per aneurysm was safe and may improve the postoperative volume and angiographic occlusion of aneurysms with a neck >4 mm, provided the sac-to-neck ratio is 1.5. 相似文献
14.
15.
Ulf Nyman Krasnodar Ivancev Mats Lindh Petr Uher 《Cardiovascular and interventional radiology》1998,21(4):305-313
Purpose: To evaluate the midterm results of percutaneous transluminal angioplasty (PTA) and stent placement in stenotic and occluded
mesenteric arteries in five consecutive patients with chronic mesenteric ischemia.
Methods: Five patients with 70%–100% obliterations of all mesenteric vessels resulting in chronic mesenteric ischemia (n= 4) and as a prophylactic measure prior to abdominal aortic aneurysm repair (n= 1) underwent PTA of celiac and/or superior mesenteric artery (SMA) stenoses (n= 2), primary stenting of ostial celiac occlusions (n= 2), and secondary stenting of a SMA occlusion (n= 1; recoil after initial PTA). All patients underwent duplex ultrasonography (US) (n= 3) and/or angiography (n= 5) during a median follow-up of 21 months (range 8–42 months).
Results: Clinical success was obtained in all five patients. Asymptomatic significant late restenoses (n= 3) were successfully treated with repeat PTA (n= 2) and stenting of an SMA occlusion (n= 1; celiac stent restenosis). Recurrent pain in one patient was interpreted as secondary to postsurgical abdominal adhesions.
Two puncture-site complications occurred requiring local surgical treatment.
Conclusions: Endovascular techniques may be attempted prior to surgery in cases of stenotic or short occlusive lesions in patients with
chronic mesenteric ischemia. Surgery may still be preferred in patients with long occlusions and a low operative risk. 相似文献
16.
Tc-99m sulfur colloid scintigraphy for detecting perigraft flow following endovascular aortic aneurysm repair: A feasibility study 总被引:2,自引:0,他引:2
David M. Hovsepian M.D. Barry A. Siegel George Kimbiris Gregorio A. Sicard Brent T. Allen Daniel Picus 《Cardiovascular and interventional radiology》1999,22(6):447-451
Purpose: To determine if scintigraphy with Tc-99m sulfur colloid can be used to detect perigraft flow after stent-graft repair of
abdominal aortic aneurysm (AAA).
Methods: Twenty-three men and two women aged 56–84 years (mean 71 years) underwent endoluminal AAA repair as part of the EVT Phase
II trial [EVT = Endovascular Technologies (Menlo Park, CA, USA)]. Aneurysm size averaged 5.4 cm (range 3–8 cm). Sixteen bifurcated,
seven tube, and two aorto-uniiliac grafts were placed. Two days after stent-graft placement, patients underwent both contrast-enhanced
computed tomography (CT), including delayed views, and Tc-99m sulfur colloid scintigraphy.
Results: Perigraft flow was found in only one patient at completion of angiography. Four additional patients had perigraft flow, discovered
during their postoperative follow-up CT. Four patients had leaks at an attachment site and one had retrograde branch flow.
Tc-99m sulfur colloid scintigraphy failed to diagnose any of the five leaks prospectively. In two of these patients, however,
some abnormal paraaortic activity was noted in retrospect.
Conclusion: Tc-99m sulfur colloid scintigraphy was unable to demonstrate endoleak with either rapid flow (attachment site leak) or slow
filling (branch flow). 相似文献
17.
《Cardiovascular and interventional radiology》1998,22(2):96-102
Purpose: To determine the efficacy of percutaneous endoluminal stents and stent-grafts for the treatment of isolated femoropopliteal
aneurysms.
Methods: Seven men (age 51–69 years) with femoropopliteal occlusions (n= 6) related to aneurysms and a patent femoropopliteal aneurysm (n= 1) were treated percutaneously. In two patients uncovered Wallstents and in five patients polyester-covered nitinol stents
were implanted. Assessment was performed with Doppler ultrasound and duplex ultrasonography 24 hr, 1, 3, 6, 12, and 24 months
after the intervention. Additionally, intraarterial angiography was performed at 6 months.
Results: Stent placement succeeded in all cases. No immediate adjunctive surgical treatment was necessary. Ankle-brachial index (ABI)
improved from 0.29 ± 0.29 (SD) before to 0.78 ± 0.23 (SD) 24 hr after the intervention. One patient was lost to follow-up.
Stent-graft occlusion occurred in four patients: after 2 days (n= 1), 1 month (n= 2), and 3 months (n= 1). One of the patients, whose stent occluded at 1 month, underwent successful recanalization with local fibrinolysis therapy.
Three of the seven, all with three-vessel run-off, demonstrated patency of the stent, which was assessed by duplex ultrasonography
at 29, 31, and 34 months. Breaking of the stent struts or significant stent migration was not observed.
Conclusions: These results in a small number of patients warrant further investigation to evaluate the role of percutaneous stents in
femoropopliteal aneurysms. Until further data of clinical studies are available, this method cannot be recommended, and it
cannot replace surgical treatment. 相似文献
18.
Strecker EP Haberstroh J Boos I Metz S Langer M Moliner MM 《Cardiovascular and interventional radiology》2004,27(3):243-250
Purpose: To present a new intravascular device for the treatment of aorto-iliac aneurysms.
Methods: This new device was tested in five dogs with abdominal aortic aneurysm created experimentally by overdilation of a balloon-expandable stent with a 16 or 18 mm wide PTA balloon catheter. The design of the device is based on a self-expanding aortic stent which consists of two stretchable circular frames filled with a textile Dacron mesh membrane that is suspended horizontally into the infrarenal abdominal aorta proximally to the aneurysm. The frames are part of a preshaped double helical structure that is introduced longitudinally through a catheter in a parallel fashion and forming the desired shape at the vessel site to be occluded. Two iliac stent-grafts are introduced in a low-profile status through the membrane sealing the aneurysm sac and holding the stent-grafts in place. After stent-graft expansion, a new bifurcation located more proximally than the natural one is created. The follow-up of the dogs was performed clinically and angiographically, and specimens were evaluated histomorphologically.
Results: The membrane device can be introduced through a 9 Fr vascular sheath. Technical success was achieved in four of five dogs. Nine of ten stent-grafts could be fixed securely within the membrane, thus preventing dislocation. Aneurysms were excluded immediately, and blood flow to the external iliac arteries was restored by the stent-grafts. At 6–9 months follow-up of technically successful implanted devices, there were no endoleaks, no migration, no stenoses at contact sites between the implant material and vascular wall, and no stenosis or occlusion of the stent-grafts. At microscopic evaluation, the interspace between the membranes was filled with thrombotic material, thus ensuring exclusion of the aneurysm.
Conclusion: This new device was found to be flexible, low profile and useful in excluding abdominal aortic aneurysm in the experimental setting. 相似文献
19.
Ernst S Fischbach R Brochhagen HG Heindel W Landwehr P 《Cardiovascular and interventional radiology》2003,26(6):516-521
We present an analysis of 37 interventions in the arteries of the lower limbs via a transbrachial arterial approach. Twenty-six patients (42–79 years) underwent 37 interventional procedures in the lower extremities (iliac n = 6, iliac + femoro-popliteal n = 1, femoro-popliteal n = 30) with a vascular approach via the brachial artery (33 left sided, 4 right sided, introducer sheath 4–7 F). The transbrachial approach was chosen to avoid puncture of femoral bypass graft material. Technical success could be achieved in 11/13 thrombolyses, 8/9 PTAs, 7/10 combinations of thrombolysis and percutaneous transluminar angioplasty (PTA) and in the placement of two stents. One patient suffered from periprocedural severe re-thrombosis due to insufficient anticoagulation during fibrinolysis, and twice thrombolysis was incomplete. One puncture-related false aneurysm of the brachial artery had to be corrected surgically. One transient ischemic attack (TIA) and four minor complications occurred. Transbrachial vascular approach for arterial interventions in iliac and femoro-popliteal pathologies is a reasonable alternative to the transaxillary access if transfemoral puncture has to be avoided. The technical success rate is comparable with the results of the transaxillary and transfemoral approach. To minimize, at least theoretically, the risk of cerebral complications, the left- sided approach should be preferred and intravenous heparin should be administered routinely. 相似文献
20.
Yamamoto S Hirota S Maeda H Achiwa S Arai K Kobayashi K Nakao N 《Cardiovascular and interventional radiology》2008,31(3):527-534
The purpose of this study was to evaluate clinical results and technical problems of transcatheter coil embolization for splenic
artery aneurysm. Subjects were 16 patients (8 men, 8 women; age range, 40-80 years) who underwent transcatheter embolization
for splenic artery aneurysm (14 true aneurysms, 2 false aneurysms) at one of our hospitals during the period January 1997
through July 2005. Two aneurysms (12.5%) were diagnosed at the time of rupture. Multiple splenic aneurysms were found in seven
patients. Aneurysms were classified by site as proximal (or strictly ostial) (n = 3), middle (n = 3), or hilar (n = 10). The indication for transcatheter arterial embolization was a false or true aneurysm 20 mm in diameter. Embolic materials
were fibered coils and interlocking detachable coils. Embolization was performed by the isolation technique, the packing technique,
or both. Technically, all aneurysms were devascularized without severe complications. Embolized aneurysms were 6–40 mm in
diameter (mean, 25 mm). Overall, the primary technical success rate was 88% (14 of 16 patients). In the remaining 2 patients
(12.5%), partial recanalization occurred, and re-embolization was performed. The secondary technical success rate was 100%.
Seven (44%) of the 16 study patients suffered partial splenic infarction. Intrasplenic branching originating from the aneurysm
was observed in five patients. We conclude that transcatheter coil embolization should be the initial treatment of choice
for splenic artery aneurysm. 相似文献