超声引导压迫修复法治疗医源性股动脉假性动脉瘤

目的探讨超声引导压迫修复法(UGCR)治疗医源性股动脉假性动脉瘤(PSA)的应用价值。方法回顾性分析25例心导管术后医源性股动脉PSA的彩色多普勒超声(CDU)表现;用CDU确定瘤口位置后,采用UGCR对股动脉PSA进行修复治疗。结果 25例医源性股动脉PSA经UGCR治疗后21例修复成功,成功率84.0%,修复时间(28.80±9.71)min;有瘤颈组压迫(6.23±2.20)min,短于无颈瘤组的(8.68±2.10)min(P<0.05);有无附壁血栓组压迫时间近似(P>0.05)。结论 UGCR在医源性股动脉PSA中修复成功率较高,压迫修复时间有瘤颈者短于无瘤颈者。     

超声引导下徒手压迫治疗股动脉假性动脉瘤

目的评价彩色多普勒超声引导下徒手压迫治疗医源性股动脉假性动脉瘤的疗效及瘤腔内不同时间的血液回声变化。方法对10例医源性股动脉假性动脉瘤进行超声引导下压迫治疗,压迫30～150min不等,观察假性动脉瘤瘤腔内回声变化及闭合情况。结果10例股动脉假性动脉瘤均压迫成功,无复发现象。结论超声引导下徒手压迫法治疗股动脉假性动脉瘤能同时对破口及瘤腔内血液回声变化进行观察,及时评价治疗效果,可以作为治疗大部分医源性假性股动脉瘤的首选方法。     

超声引导下瘤腔内注射凝血酶治疗股动脉假性动脉瘤的临床研究

目的:评价超声引导下瘤内注射凝血酶治疗股动脉假性动脉瘤的应用价值。方法:入选33例经皮冠脉介入治疗术后形成的股动脉假性动脉瘤患者。采用超声引导下,于超声探头压迫瘤颈同时,瘤腔内注射凝血酶(浓度为100 U/mL)。分析假性动脉瘤的类型、大小、瘤径长度及宽度、凝血酶用量及其疗效,观察其并发症。结果:33例患者中,单纯型25例,复杂型8例。动脉瘤平均体积为(9.0±5.0)cm3,瘤颈部宽度(2.7±0.7)mm,颈部长度(5.9±0.9)mm,平均凝血酶用量(299±110)U。30例一次成功,3例第一次注射后复发,经第二次注射后成功,其中单纯型1例,复杂型2例。未发生动脉或静脉栓塞等并发症。术后随访3个月无复发。与单纯型相比,复杂型动脉瘤患者年龄更大,女性更多,体重指数及瘤腔体积更大,所需凝血酶剂量更多(P0.05);两者在瘤径长度及宽度方面差异无统计学意义(P0.05)。结论:超声引导下瘤腔内注射凝血酶治疗股动脉假性动脉瘤操作简便,疗效好,安全性高,可作为介入术后股动脉假性动脉瘤的首选治疗方法。     

彩色多普勒超声引导下注射凝血酶并加压治疗股动脉穿刺后假性动脉瘤

目的:探讨超声引导下瘤腔内注射凝血酶并加压治疗股动脉假性动脉瘤的疗效和安全性。方法:7例股动脉穿刺后并发假性动脉瘤患者,在超声引导下进行瘤腔内注射凝血酶并加压治疗。结果:6例注射凝血酶剂量300-500 U,压迫时间3-8 min,一次性栓塞成功;仅1例进行二次封堵术,栓塞治疗成功。结论:超声引导下瘤腔注射凝血酶并加压治疗方法相比传统的单纯超声引导下按压治疗简单,安全,成功率高,可作为穿刺术后假性动脉瘤的首选治疗方法。凝血酶注射剂量和注射后按压时间是减少并发症和保证疗效的重要因素。     

超声引导下经皮凝血酶注射对医源性股动脉复杂假性动脉瘤的应用研究

目的 彩超引导下医源性股动脉复杂假性动脉瘤(IFACP)腔内经皮凝血酶注射治疗(UGTI)方法学及可行性评价.方法 回顾性分析32例经股动脉径路进行介入操作术后并发IFACP患者接受经皮凝血酶注射治疗.假性动脉瘤瘤腔数目为2腔23例,3腔8例,4腔1例;局部麻醉后彩超持续引导下动脉穿刺针依次进入各瘤腔进行凝血酶注射,动态观察瘤腔内血栓形成完成封堵,24 h,7d后分别彩超随访.结果 23例2腔全部一次性成功,2例3腔24 h后复查部分再通,再次行UGTI封堵失败,1例4腔封堵失败,均无血栓形成、栓塞、感染、过敏等并发症.结论 彩超引导下UGTI是治疗股IFACP首选术式,精准定位穿刺可提高复杂假性动脉瘤治疗成功率,避免严重并发症.     

超声引导注射凝血酶治疗股动脉假性动脉瘤的研究进展

【摘要】 随着介入检查及治疗的广泛开展,医源性股动脉假性动脉瘤逐年增多,但仅部分能自愈。既往外科手术为“金标准”,但因其创伤大、并发症多而使用受限。近年来,超声引导下经皮凝血酶注射治疗医源性股动脉假性动脉瘤因疗效好、创伤小、恢复快、费用低等优点在临床中广泛应用,甚至作为一线治疗选择方案。本文就该方法治疗医源性股动脉假性动脉瘤的进展作一综述。     

超声引导下小剂量凝血酶注射治疗医源性股动脉假性动脉瘤

目的 研究超声引导下凝血酶注射在医源性股动脉假性动脉瘤治疗中的应用价值。方法 在彩色超声多普勒引导下,采用21G PTC 针经皮穿刺,对2010 年5 月- 2013 年4 月本院介入超声科的39 例医源性股动脉假性动脉瘤患者瘤内注射凝血酶（250 U/ml,总量均≤ 150 U）。结果 39 例均成功行超声引导下凝血酶注射治疗,瘤腔内血流信号均消失,但3 例术后瘤颈处可见少许血流信号,术中、术后无并发症发生,术后无复发。结论 超声引导下凝血酶注射治疗医源性股动脉假性动脉瘤操作简便、临床疗效可靠、并发症少、复发率低,临床应用价值较高。     

超声引导下压迫修复联合凝血酶注射治疗假性动脉瘤

目的探讨超声引导下压迫修复联合凝血酶注射治疗假性动脉瘤的临床价值。方法对32例假性动脉瘤患者,在超声引导下压迫封闭瘤腔与载瘤动脉间的通道,同时保证栽瘤动脉远端血运通畅。超声监示下使用22G或20G细针徒手穿刺进入假性动脉瘤残腔,注入凝血酶。用二维和彩色多普勒超声观察瘤体内血栓形成情况。血栓充分形成后观察载瘤动脉及其远端动脉,确定其通畅。结果32例假性动脉瘤在超声引导下压迫修复联合凝血酶注射治疗均获成功,封闭成功率达100％,无中转外科治疗患者,无动脉栓塞、过敏反应等并发症发生。其中1例术后第三天复发,再次应用上述方法治疗后痊愈。结论超声引导下压迫修复联合凝血酶注射治疗假性动脉瘤安全、实用,可在临床推广应用。     

超声引导下注射凝血酶治疗医源性假性动脉瘤

目的:评价超声引导下瘤腔内注射凝血酶在治疗医源性股动脉假性动脉瘤中的应用价值。方法:在彩色多普勒超声引导下,采用5ml注射器经皮穿刺,对23例经股动脉介入术后股动脉假性动脉瘤患者行瘤腔内注射凝血酶封闭,凝血酶浓度为200 U/ml,总量均≤500 U。结果:23例患者均1次治疗成功,术中、术后无并发症发生,术后无复发。结论:在彩色多普勒超声引导下凝血酶封闭治疗假性动脉瘤创伤小,操作简便,疗效确切,可作为介入术后假性动脉瘤的首选治疗方法。     

超声引导下注射凝血酶治疗假性动脉瘤1例

1 病情简介 张××(病案号0468942),女性,57岁,既往高血压多年,最高达为160/100mmHg,平素口服北京降压0号片(1片,每日1次),血压控制在120/80 mmHg左右;以"间断胸痛半年,加重十天"于2006年4月11日07时45分入我院心脏内科.     

Comparison of ultrasound-guided thrombin injection and compression repair in treatment of iatrogenic femoral arterial pseudoaneurysms

Objective:To retrospectively compare the efficacy and safety of ultrasound-guided thrombin injection (UGTI) with ultrasound-guided compression repair (UGCR) in patients with postcatheter-izational femoral arterial pseudoaneurysms (PSA). Methods: Thirty patients of this iatrogenic PSA [8 males, 22 females, average age (66. 5±5. 2) years] in our institution from 1997 to 2004 were retrospectively analyzed. Among them, 11 patients were treated with UGCR, 2 under continuous ultrasonographic (US) guidance and 9 under the guidance of femoral arterial bruit auscultation and dorsalis pedis artery palpation. Because UGCR was failed in 5 patients, consecutively 24 patients were treated with UGTI. Swine thrombin solution at a concentration of 200 U/ml was injected percutaneously using 22-25 gauge needles under color Doppler US. Demographics, clinical variables, pseudoaneurysm characteristics, and results of the 2 groups were compared by using Fisher's exact test and Student's t test. Results: The initial success rate of UGCR was 36. 4% (4/11) and the overall success rate was 45. 5% (5/11). Ten of 11 patients suffered from local pain during the compression, but there was no any complication in UGTI group. The average dose of injected thrombin was (180 + 82) U for PSA of a single loculus and (315±150) U for multiloculated PSA. The initial success rate of UGTI was 89.5% (17/19) and the overall success rate was 100% (24/24). Conclusion;UGTI offers a safe, quick and effective means of definitively treating femoral pseudoaneurysms and seems superior to UGCR. The amount of thrombin applied on our people seems smaller compared with others' work.     

假腔内注射凝血酶治疗股动脉假性动脉瘤(附6例临床分析)

目的：探讨超声引导下假腔内注射凝血酶对股动脉假性动脉瘤的治疗效果。方法：对本科1999年9月－2002年8月行心脏介入诊疗后并发的6例右侧股动脉假性动脉瘤进行假腔内凝血酶注射治疗，并对其结果进行了分析。结果：6例患者均即刻治疗成功，未见明显并发症，随访30d无复，结论：假腔内注射血酶是一种安全，简便，快速，耐受性佳，经济和有效的治疗股动脉假性动脉瘤的方法。     

超声引导下凝血酶注射法治疗股动脉假性动脉瘤的临床研究

目的评价超声引导下瘤腔内注射凝血酶治疗医源性假性动脉瘤的临床应用价值。方法冠状动脉介入诊治术后股动脉假性动脉瘤（PSA）患者16例,在超声引导下穿刺PSA瘤腔并注射200u凝血酶行封闭治疗,所有病例均在治疗后24h和3～5d复查超声。结果11例患者在瘤囊内注入200u凝血酶后瘤腔即刻闭合,5例患者动脉与瘤腔通道血流明显减弱,在超声指引下压迫5～10min闭合,治愈率100%,无并发症发生。所有病例24h及3～5d后复查无复发。结论该法治疗PSA简便、安全、有效,可作为临床治疗PSA的首选方法。     

Ultrasound-guided thrombin injection versus ultrasound-guided compression therapy of iatrogenic femoral false aneurysms: Single center experience

BackgroundIatrogenic femoral pseudoaneurysm (false aneurysm) due to arterial access following cardiovascular procedures is becoming common because of the increase in number and complexity of the procedures. Recently, percutaneous thrombin injection is becoming a popular treatment of these false aneurysms.The aim of this study was to assess the efficacy and safety of femoral pseudoaneurysm closure using ultrasound-guided thrombin injection in comparison to ultrasound-guided compression.MethodsA retrospective analysis was undertaken of 65 patients who presented to our vascular department with iatrogenic femoral pseudoaneurysm between January 2015 and March 2019. Twenty-five patients underwent ultrasound-guided thrombin injection, and 40 were treated using ultrasound-guided compression therapy. The primary outcome measured was efficacy, while other outcomes examined were safety, procedure duration, and cost.ResultsA total of 65 patients (45 males, 20 female) were identified with a mean age of 62 years. Out of the 65, 40 patients (28 males, 12 female) underwent ultrasound-guided compression therapy (group A) with a mean aneurysm size of 2.9 cm, and 25 (17 male, 8 female) underwent ultrasound-guided thrombin injection (group B) with a mean pseudoaneurysm sac size of 3.7 cm. The success rate of thrombosis in group A was 70% and in group B was 92%. No significant complications were reported in both groups.ConclusionsUltrasound-guided thrombin injection should be considered as the first line of treatment for uncomplicated femoral pseudoaneurysms because it has a higher thrombosis and lower recurrence rates, when compared with ultrasound-guided compression treatment.     

超声引导下瘤腔内注射凝血酶治疗IFAP合并动静脉瘘

目的采用超声引导下瘤内注射凝血酶（UGTI）治疗医源性股动脉假性动脉瘤（IFAP）合并动静脉瘘。方法冠状动脉介入诊治术后IFAP患者32例,其中9例合并动静脉瘘。所有患者均接受UGTI治疗,并于术后3、14和30d定期进行超声复查。结果 31例患者一次治疗成功,1例失败转行外科手术治疗。31例患者术后随访,均无IFAP复发以及栓塞和过敏反应等并发症发生。结论 UGTI治疗IFAP具有较高的临床价值,对合并动静脉瘘者同样安全、有效。     

Successful treatment of spontaneous rupture of the internal carotid artery in an acute nonlymphocytic leukemia patient using ultrasound-guided thrombin injection: A case report and literature review

Spontaneous rupture and bleeding from the carotid artery in acute nonlymphocytic leukemia (ANLL) patients leading to pseudoaneurysm (PSA) formation has not been reported, nor has the use of ultrasound-guided thrombin injection (UGTI) for the treatment of carotid artery pseudoaneurysms. We report a case of acute nonlymphocytic leukemia (ANLL) with left internal carotid artery rupture during chemotherapy leading to a left-sided cervical PSA, successfully treated with UGTI, providing a simple, safe and effective method to treat patients with malignant tumors suffering from spontaneous vascular rupture.     

超声定位压迫治疗医源性假性动脉瘤临床用价值

目的 探讨彩色多普勒超声(CDFI) )引导下对医源性股动脉假性动脉瘤(PSA)的定位压迫及凝血酶注射治疗的临床价值。方法 对 11 例经皮穿刺介入性检查及微创治疗术后,穿刺部位发现搏动性肿块或者听诊有血管杂音,并经超声检查确诊为股动脉假性动脉瘤的患者,行超声引导下压迫及注射治疗。结果 一次性压迫成功率为 54.5%（6/11）,2 例重复压迫成功。其余 3 例重复压迫不成功者改为超声引导下瘤腔内注射凝血酶,使瘤腔闭塞。术后一个月复查均无复发,超声对医源性假性动脉瘤治疗总的治愈率为 100%。 结论 彩色多普勒超声引导下定位压迫结合瘤腔内注射凝血酶治疗医源性假性动脉瘤是一种简便、无创、疗效显著、值得推广的方法。     

超声引导下局部压迫和凝血酶注射治疗假性动脉瘤的临床观察

目的探讨彩色多普勒超声引导下局部压迫和凝血酶注射共同治疗假性动脉瘤的临床应用。方法在彩色多普勒超声引导下,局部压迫的同时采用八光20G穿刺针经皮穿刺,对22例假性动脉瘤患者行瘤腔内注射凝血酶封闭,凝血酶浓度为200U/ml,总量均≤500U。结果 22例患者均一次性治疗成功。结论超声引导下局部压迫和凝血酶注射共同治疗假性动脉瘤创伤小,操作简便,疗效确切,可作为假性动脉瘤外科修补术的替代治疗方法。