经动脉栓塞治疗肾动静脉畸形或瘘所致血尿

目的评价经动脉栓塞治疗肾动静畸形(或瘘)所致血尿的安全性和疗效。方法回顾性分析因肉眼血尿行肾动脉造影而确诊的肾血管病变7例,包括先天性肾动静脉畸形3例,非肿瘤获得性动静脉瘘4例,选择相应的栓塞剂行动脉栓塞治疗。结果7例均获成功栓塞,术后1～7d临床肉眼血尿症状完全消失,无严重并发症,随访l2～36个月无再发。结论经动脉栓塞治疗肾动静脉畸形或瘘所致的血尿安全、有效。     

经动脉导管栓塞治疗经皮肾盂穿刺取石术后迟发性出血的多中心回顾性研究

<正>目的确定经动脉导管栓塞术(TAE)治疗经皮肾盂穿刺取石术(PCNL)后迟发性出血的时间和指征。方法回顾性分析2005年1月—2012年12月间5所大学医院中接     

肾动,静脉瘘致持续性血尿的栓塞治疗

肾动、静脉瘘致持续性肉眼血尿是很少见的病例,笔者使用5F 导管超选肾动脉及其分支并用碘化油栓塞治疗由肾动、静脉瘘引起的持续性血尿患者2例。现报告如下。     

经皮肾镜取石术后肾动脉损伤造影表现及栓塞治疗

目的：探讨经皮肾镜取石术（PCNL）后肾动脉损伤肾动脉造影表现及超选择性肾动脉栓塞术（SRAE）治疗效果。方法收集2010年1月至2014年6月PCNL术后出现持续性或间歇性肉眼血尿患者共22例,均经肾动脉造影证实为肾动脉损伤,并接受SRAE术治疗,栓塞材料为微弹簧圈。术后随访3个月。结果22例患者中DSA造影表现为肾动脉假性动脉瘤（RAP）14例（63.6%）,肾动静脉瘘（RAVF）5例（22.7%）,RAP伴发RAVF 3例（13.6%）。 SRAE术后肾动脉造影显示病变均达到完全栓塞,所有患者活动性出血停止,技术成功率及有效止血率均为100%。术后随访3个月,22例患者均未见血尿复发及严重并发症。20例患者术后出现不同程度的栓塞综合征。结论 RAP、RAVF是PCNL术后肾动脉损伤的主要类型,采用微弹簧圈行SRAE可作为经保守治疗无效患者的首选治疗方法。     

选择性肾动脉栓塞治疗经皮肾镜取石术后大出血的临床价值

目的：探讨用弹簧圈、聚乙烯醇颗粒（PVA）选择性肾动脉栓塞治疗经皮肾镜取石术（MPCNL）术后大出血的临床价值。方法：回顾性分析27例MPCNL术后大出血患者的肾动脉造影表现、栓塞治疗效果及并发症等。结果：MPC-NL术后出血的原因包括单纯假性动脉瘤13例（48.1%）、假性动脉瘤伴动静脉瘘2例（7.4%）、动-静脉瘘8例（29.6%）、对比剂外渗2例（7.4%）,2例（7.4%）未发现异常。27例中26例1次、1例2次栓塞成功,27例全都保留了病肾的大部分组织和功能,无严重并发症,术后1个月~2年随访,肾功能良好,无再出血发生。结论：选择性肾动脉栓塞创伤小,见效快,能最大限度保留肾脏功能,可作为MPCNL术后严重出血的首选治疗方法。     

选择性肾动脉栓塞在经皮肾镜取石术后迟发性肾出血中的应用

目的 探讨选择性肾动脉栓塞在经皮肾镜取石(PCNL)术后迟发性肾出血中的应用价值.方法 2010年2月至2011年7月对515例患者行PCNL术,其中25例术后2 ～ 7 d发生迟发性肾出血.出血部位右肾16例、左肾9例.对25例患者均行栓塞治疗,栓塞材料采用明胶海绵、聚乙烯醇(PVA)颗粒或弹簧圈.结果 造影见出血原...     

外伤性肾动脉假性动脉瘤的超选择性栓塞治疗

肾动脉假性动脉瘤(renal arterial pseudoaneurysm,RAP)临床上很少见,其破裂出血可造成严重后果,临床处理相当困难.近年来,我们采用超选择性插管栓塞方法治疗RAP患者共3例,现报道如下.     

超选择性肾动脉栓塞术治疗肾癌性血尿的效果观察

目的：评价超选择性肾动脉栓塞术治疗肾癌性血尿的临床效果。 方法：回顾性分析2015年1月至2018年1月内蒙古科技大学包头医学院第一附属医院介入治疗科收治的肾癌性血尿患者39例,男22例,女17例。患者经辅助检查均诊断为肾癌性血尿,均接受超选择性肾动脉栓塞术。术后第2、7、14、21天留取患者血液及尿液样本,行血常规及尿常规化验。 结果：39例患者均采用超液态碘油+明胶海绵微粒+明胶海绵颗粒栓塞,均一次栓塞成功,成功率达100%。其中,21例患者术后12 h肉眼血尿消失,18例术后24 h肉眼血尿消失。术后第2、7、14、21天,血红细胞数（RBC）、血红蛋白（Hb）、血细胞比容（HCT）水平均高于术前,尿RBC低于术前,差异均有统计学意义（P<0.01）。39例患者行栓塞术后均出现不同程度的栓塞综合征,临床表现为恶心、呕吐、发热及腰背胀痛等症状,经对症治疗2~5 d后消失。38例术后随访3~12个月,无一例发生异位栓塞、急性肾功能衰竭、肾坏死、肾脓肿等并发症。 结论：超选择性肾动脉栓塞术治疗肾癌可以起到终止血尿的作用,且有微创、安全可靠、并发症少等优点。     

超选择性动脉栓塞治疗急性肾出血

目的 探讨超选择性肾动脉栓塞治疗急性肾出血的价值.方法 采用4 F导管或(和)2.7 F微导管注入钢圈或(和)微钢圈、聚乙烯醇颗粒超选择性肾动脉栓塞治疗17例严重肾出血患者.5例患者于术前行多层螺旋CT血管造影(CTA)检查,9例患者于术后4 d～54个月行CT平扫、增强扫描与CTA检查.结果 17例患者均一次性介入...     

超选择性动脉栓塞治疗顽固性鼻出血

目的 评价超选择性动脉栓塞治疗顽固性鼻出血的临床应用价值.方法 27例经常规治疗无效的顽固性鼻出血患者,采用Seldinger技术,将导管超选择性插管至颈外动脉分支内,造影证实出血部位后,采用明胶海绵颗粒或/和聚乙烯醇(PVA)颗粒行动脉栓塞治疗.结果 27例顽固性鼻出血患者均发现出血动脉,栓塞治疗全部成功,术后即刻拔除鼻腔填塞物,出血停止,未见严重并发症.结论 超选择性动脉栓塞术治疗顽固性鼻出血是一种安全有效的治疗方法,值得临床推广应用.     

头颈部富血管病变超选择动脉插管栓塞治疗

探讨头颈部富血管病变栓塞治疗的效果,可能的并发症和处理方法。材料与方法,对５９例患 颈外动脉分支超选择插管以后,用ＩＢＣＡ,明胶海绵或线段进行栓塞治疗。结果部分患者栓塞即获得根效果,部分患者在栓塞后进行手术治疗。术中观察,肿块缩小,出血明显减少。     

大肠癌的超选择性动脉灌注化疗和栓塞治疗

目的 :对大肠癌的选择性动脉灌注化疗和栓塞治疗的临床价值进行探讨。方法 :对 2 0例大肠癌病人行选择性血管造影及超选择性插管化疗和明胶海绵栓塞 ;原发性大肠癌 14例于介入治疗后 1周内手术 ;复发性大肠癌 6例 ,行一次导管治疗 2例 ,二次 2例 ,三次 2例。结果 :14例化疗栓塞后根治性切除 12例 ,术中出血明显减少 ,姑息性化疗组临床症状明显改善。结论 :大肠癌超选择性动脉灌注化疗和栓塞可改善临床症状 ,提高手术切除率 ,是治疗大肠癌的有效方法之一。     

医源性全血尿:动脉造影与栓塞治疗

目的探讨医源性血尿的动脉造影诊断及其血管内介入治疗的价值。资料与方法 24例医源性血尿患者,依据其临床治疗经过,采用Seldering技术行一侧股动脉穿刺插管,选择性行患侧肾动脉或双侧髂内动脉造影,以微导管行超选择性造影,明确出血原因、具体部位,以明胶海绵碎屑或/并微弹簧圈栓塞。最后行栓塞后造影,观察栓塞情况。结果 24例动脉造影均获得明确诊断,其中经皮肾盂穿刺造瘘术后局部肾动脉小分支损伤、局部假性动脉瘤形成、全血尿8例,经皮肾穿刺取石术后肾动脉小分支损伤全血尿6例,超声碎石术后肾实质损伤全血尿2例,前列腺癌、前列腺增生症摘除术后手术区渗血、全血尿7例,男性尿道医源性损伤出血1例。所有病例栓塞治疗后止血效果明显,无并发症发生。结论对于医源性全血尿患者,依据其临床治疗经过,行患侧肾动脉或双侧髂内动脉造影具有定性定位诊断价值,经微导管对所涉动脉分支超选择性栓塞能成功控制出血。     

Superselective Transcatheter Arterial Embolization for Large Unruptured Renal Angiomyolipoma in Lymphangioleiomyomatosis

Purpose

To retrospectively evaluate therapeutic performance and complications of superselective transcatheter arterial embolization (TAE) for unruptured renal angiomyolipoma (AML) in patients with lymphangioleiomyomatosis (LAM) and to investigate the correlation between percentage reduction in tumor volume and intratumoral fat content.

Percutaneous Cyanoacrylate Glue Injection into the Renal Pseudoaneurysm to Control Intractable Hematuria After Percutaneous Nephrolithotomy

We report a case of a 43-year-old man who developed intractable hematuria after percutaneous nephrolithotomy. Angiography detected a pseudoaneurysm arising from the lower polar artery; however, embolization could not be performed because of unfavorable vascular anatomy. A percutaneous thrombin injection under ultrasound guidance initially controlled the bleeding, but hematuria subsequently recurred as a result of recanalization of the aneurysm. The case was successfully managed with ultrasound- and fluoroscopic-guided direct injection of cyanoacrylate glue into the pseudoaneurysm.     

Prostatic Arterial Embolization for Control of Hematuria in Patients with Advanced Prostate Cancer

Nine patients with advanced prostate cancer (stage T4) underwent prostatic arterial embolization (PAE) for refractory prostatic hematuria. Angiograms showed prostatic neovascularity in all cases, and complete PAE was achieved in 8 cases (89% technical success rate). Gross hematuria ceased after PAE in 6 cases, translating to a 67% clinical success rate. There were no PAE-related complications. At 3-month follow-up, 2 cases showed recurrent hematuria, 4 patients had died from PAE-unrelated etiologies, and only 3 patients survived and were without gross hematuria. PAE could represent an alternative option for patients with advanced prostate cancer to control hematuria.     

Balloon-Occluded Percutaneous Transhepatic Obliteration of Isolated Vesical Varices Causing Gross Hematuria

Gross hematuria secondary to vesical varices is an unusual presentation. We report such a case recurrent gross hematuria in a male patient who had a history of bladder substitution with ileal segments that had been treated by balloon-occluded percutaneous transhepatic obliteration of vesical varices.     

Transcatheter Arterial Embolization for Hepatic Arterial Injury Related to Percutaneous Transhepatic Portal Intervention

Purpose

To assess the usefulness of transcatheter arterial embolization (TAE) for the hepatic arterial injury related to percutaneous transhepatic portal intervention (PTPI).

Materials and Methods

Fifty-four patients, 32 males and 22 females with a median age of 68 years (range 43–82 years), underwent PTPI. The procedures consisted of 33 percutaneous transhepatic portal vein embolizations, 19 percutaneous transhepatic variceal embolizations, and 2 percutaneous transhepatic portal venous stent placements. Two patients with gastric varices underwent percutaneous transhepatic variceal embolization twice because of recurrence. Therefore, the total number of procedures was 56. Among them, hepatic arterial injury occurred in 6 PTPIs in 5 patients, and TAE was performed. We assessed technical success, complications related to TAE, and clinical outcome. Technical success was defined as the disappearance of findings due to hepatic arterial injury on digital subtraction angiography.

Results

As hepatic arterial injuries, 4 extravasations and 2 arterioportal shunts developed. All TAEs were performed successfully. The technical success rate was 100 %. Complication of TAE occurred in 5 of 6 TAEs; 3 were focal liver infarction, not requiring further treatment, and 2 were biloma that required percutaneous drainage. Five TAEs in 4 patients were performed immediately after the PTPI, and these 4 patients were alive. However, one TAE was performed 10 h later, and the patient died due to multiple organ failure 2 months later although TAE was successful.

Conclusion

TAE is a useful treatment for hepatic arterial injury related to PTPI. However, it should be performed at an early stage.