球囊阻断在股动脉假性动脉瘤手术中的应用

目的 探讨球囊阻断在股动脉假性动脉瘤手术中的临床价值.方法 回顾性收集柳州市人民医院2017年2月至2020年2月采用球囊阻断下手术治疗25例股动脉假性动脉瘤患者的临床资料,分析手术成功率、手术时间、术中出血量和术后并发症情况.结果 患者均成功置入球囊导管并完成手术,平均手术时间(72.7±11.2)min,平均出血量...     

1例假性动脉瘤患者瘤腔内注射凝血酶的护理

对1例假性动脉瘤患者在超声引导下局部注射凝血酶，注射后彩色多普勒血流显像示假性动脉瘤内血液凝固,血流信号消失。提示瘤腔内注射凝血酶治疗假性动脉瘤创伤小、效果好、安全易行。而完善术前准备，术中密切配合，术后加强并发症的观察是保证治疗成功的关键。     

1例假性动脉瘤患者瘤腔内注射凝血酶的护理

对1例假性动脉瘤患者在超声引导下局部注射凝血酶,注射后彩色多普勒血流显像示假性动脉瘤内血液凝固,血流信号消失.提示瘤腔内注射凝血酶治疗假性动脉瘤创伤小、效果好、安全易行.而完善术前准备,术中密切配合,术后加强并发症的观察是保证治疗成功的关键.     

肱动脉假性动脉瘤腔内注射凝血酶的研究

随着经皮穿刺动脉介入诊疗的日益增多,与之相应的因穿刺动脉后闭合不良而发生的穿刺动脉假性动脉瘤也有逐渐增多趋势.它不但增加患者的痛苦,而且也增加了患者的经济负担.如何减少其发生,我们进行了临床研究.既往常规处理方法为局部压迫与外科修复,近期我们在借鉴国外经验的基础上,对临床出现的假性动脉瘤,经压迫无效时,在B超引导下假腔内注射凝血酶的方法成功封闭了 3例肱动脉假性动脉瘤.现将体会报告如下.     

肱动脉假性动脉瘤腔内注射凝血酶的作用

探讨超声引导下假腔内注射凝血酶对肱动脉假性动脉瘤的治疗效果。资料与方法自2000年1月至2004年3月,3例尿毒症患者,穿刺透析后出现假性血管瘤,压迫观察24～48h无效后再采用假腔内注射凝血酶。男性1例,女性2例,年龄31～48岁。主要表现为穿刺肢体高度肿胀、疼痛、搏动性包块及震颤,听诊有血管杂音,彩色超声示病变部位有往返血流信号。用注射器在超声引导下刺入假瘤腔1cm,回抽见动脉血,在5～10s内注入内含500U凝血酶盐水1ml,拔针压迫穿刺点5min。超声显示肱动脉与假性动脉瘤之间的血流消失为成功,回病房后平卧、制动,患肢抬高6h。结果上述3例…     

超声引导下凝血酶注射封堵术治疗医源性股动脉假性动脉瘤的临床应用

目的 探索影响超声引导下凝血酶注射(UGTI)治疗医源性股动脉假性动脉瘤(IFAP)封堵有效性的超声形态学指标.方法 回顾性收集2015-2017年期间在四川大学华西医院血管外科接受UGTI治疗且符合研究条件的IFAP患者,分析其人口学数据、合并症情况、临床症状、超声形态学参数、凝血酶用量等资料,并通过logistic...     

外伤性颈内动脉假性动脉瘤的血管内栓塞治疗

报告４例外伤性颈内动脉海绵窦段假性动脉瘤经血管内栓塞治愈头面部外伤，颅风底骨折和迟发性周期性鼻衄是论断外伤性颈内动脉假性动脉瘤的主要依据，可脱球囊内充ＨＥＭＡ栓塞动脉瘤及颈内动脉２例，钨线螺旋圈栓塞脉瘤１例，螺旋圈和可脱球囊联合栓塞动脉瘤１例，后２例颈内动脉通畅，血管内栓塞治疗是外伤性颈内动脉性动脉瘤的最佳治疗方法。     

血管重建治疗注射毒品所致股动脉假性动脉瘤

目的探讨注射毒品所致股动脉假性动脉瘤的外科治疗方法。方法对14例注射毒品所致股动脉假性动脉瘤患者的临床资料进行回顾分析。9例直接采用ePTFE人工血管行原位移植间置术;4例采用自体大隐静脉原位间置移植术;1例行单纯股深动脉结扎术。结果全部病例术后患肢供血良好,无肢体缺血表现,其中11例患者成功随访1～45个月,1例患者出院后出现伤口感染,余患者伤口均在1个月内愈合,现患肢均无缺血症状,活动自如。结论吸毒所致股动脉假性动脉瘤切除后血管重建有利于保证下肢血供,在患者不能提供合适的自体大隐静脉移植时,人工血管原位移植仍是治疗假性股动脉瘤的有效方法。术中彻底清创及术后伤口引流、加强抗炎是预防术后人工血管并发感染的最主要措施。     

超声引导下瘤内注射凝血酶治疗医源性股动脉假性动脉瘤

随着抗凝及抗血小板药物的大量应用及介入治疗新技术的不断开展,医源性股动脉假性动脉瘤（iatrogenic femoral artery pseudoaneurysm,IFAP）已成为经股动脉入路行有创检查和介入治疗的常见并发症。其发生率在行有创检查时为0.2％～0．5％,介入治疗时为2％～8％。我们在超声引导下对5例由于介入性诊断或治疗所致的IFAP患者行瘤内注射凝血酶治疗,并使瘤腔成功闭合,现将治疗体会报道如下。     

假性动脉瘤的治疗

１９６５年８月～１９９２年１２月，收治２９例假性动脉瘤患者，分别采用四种不同的手术方法治疗：①血管结扎术。②动脉修补术。③瘤体切除，血管直接吻合术。④瘤体切除或者旷置，血管移植术。其中，以血管吻合和血管移植修复效果最好。认为：如果病变的局部条件允许时，应尽早手术，防止假性动脉瘤逐渐增大，导致手术更加困难。     

Traumatic pseudoaneurysm of the anterior tibial artery treated with ultrasound-guided thrombin injection in a pediatric patient

Pseudoaneurysms are relatively common in the adult population because of the high volume of procedures requiring large bore arterial access. This experience has allowed adult caregivers to develop simple maneuvers to treat pseudoaneurysms such as ultrasound-guided thrombin injection. However, because of the extremely low volume of pseudoaneurysms seen by pediatric caregivers, this modality has not been well documented in the pediatric population. Here, we present a case of a 13-year-old female who had a stab wound to her left leg and subsequently developed a pseudoaneurysm of the anterior tibial artery that was successfully treated with ultrasound-guided thrombin injection.     

Treatment of pancreatic pseudoaneurysm with percutaneous transabdominal thrombin injection

Severe acute pancreatitis is associated with significant morbidity and mortality. Although rare, pancreatic pseudoaneurysm is a serious and often fatal complication of acute pancreatitis. This case report describes an alcoholic male patient with a psuedoaneurysm that was successfully treated with percutaneous transabdominal thrombin injection.     

Femur ostochondroma and secondary pseudoaneurysm of the popliteal artery

Osteochondroma is the most common skeletal benign tumour. It may present in a solitary form or as part of an autosomal dominant hereditary syndrome affecting several bones simultaneously. It is found most often in the knee region. It is generally asymptomatic although it may cause complications, including vascular disorders. In view of anatomical circumstances, the popliteal artery is most frequently involved in this type of complication. This is a case report of a 9-year-old boy who referred with pain in the distal third of his femur. Osteochondroma was initially diagnosed through plain X-ray. In view of worsening symptoms, an ultrasound and magnetic resonance imaging were performed and the patient was diagnosed with pseudoaneurysm of the popliteal artery.     

Safety and effectiveness of combined scoring balloon and paclitaxel-coated balloon angioplasty for stenosis in the hemodialysis access circuit

Purpose

To evaluate the safety and effectiveness of combined scoring balloon (SB) and paclitaxel-coated balloon (PCB) angioplasty for stenosis in the dysfunctional hemodialysis access circuit.

经皮腔内顺行球囊扩张结合内切开术治疗肾盂输尿管连接部梗阻

目的观察经皮腔内顺行球囊扩张结合内切开术治疗肾盂输尿管连接部梗阻(UPJO)的疗效。方法回顾分析2010年3月至2012年9月我院采用经皮腔内顺行球囊扩张结合内切开术治疗肾盂输尿管连接部梗阻23例患者的病例资料并行随访。结果患者23例,男性14例,女性9例;年龄21~71岁,平均(39±10.5)岁;左侧10例,右侧13例;原发性UPJO 18例(合并肾结石12例),经皮肾镜碎石术后2例,肾盂输尿管连接部结石开放取石术后1例,开放肾盂成形术后1例,腹腔镜肾盂成形术后1例,狭窄段长度均不超过2cm。所有患者均手术成功,围手术期无严重并发症发生。17例患者纳入随访,其中原发性UPJO患者12例,经皮肾穿刺取石术(PCN)术后患者2例,开放输尿管切开取石术后1例,腹腔镜下肾盂成形术后1例,开放肾盂成形术后1例,术后随访7~31月,未见复发。结论经皮腔内顺行球囊扩张结合内切开术是治疗UPJO安全、有效的手术方式,具有微创、患者耐受度好、术后恢复快的特点,可有选择性地作为治疗UPJO的初始治疗手段。     

Treatment of spontaneous lumbar artery pseudoaneurysm by computed tomography--guided thrombin injection

A case of spontaneous pseudoaneurysm of a lumbar artery that was treated with computed tomography- guided thrombin injection is reported in this study. To the authors' knowledge, pseudoaneurysm of lumbar artery without any predisposing factors has been reported only twice in the literature previously. The aims of this case report are to discuss the differential diagnosis and management of this difficult problem.     

Management of femoral artery pseudoaneurysm due to addictive drug injection

Objective: To study surgical management for patients with femoral pseudoaneurysm resulting from addictive drug injection. Methods： Clinical data of 34 patients with femoral pseudoaneurysm resulting from addictive drug injection were retrospectively reviewed. Results: Thirteen patients underwent bypass graft ( end to side) of external iliac artery and superficial femoral artery using expanded polytetrafluoroethylene (ePTFE). Three patients who had an autogenous saphenous vein graftin situs, one of whom was then performed an ePTFE graft when rupture and bleeding occurred at the anastomotic site. Color Doppler image showed patent grafted blood vessels in all the patients after operation. Eighteen patients had their femoral arteries ligated. Limbs of all the 34 patients were saved. Conclusions： Ligating femoral artery is an effective way to treat femoral artery pseudoaneurysm if autogenous saphenous vein graft or artificial vessel graft is not applicable.     

腔内减容联合药物涂层球囊在复杂股腘动脉支架内再狭窄的应用

目的：探讨TurboHawk腔内减容联合药物涂层球囊（DCB）处理复杂股腘动脉支架内再狭窄（ISR）的安全性和有效性。 方法：对2017年5月—2018年5月间21例股腘动脉ISR的患者采用TurboHawk腔内减容联合DCB治疗。其中男13例（61.9%）,女8例（38.1%）;术前ABI为0.45±0.14;Rutherford分级为2级1例（4.7%）,3级3例（14.3%）,4级7例（33.3%）,5级8例（38.1%）,6级2例（9.5%）;Tosaka I级2例（9.5%）,II级7（33.3%）,III级12（57.1%）。 结果：21例患者均获技术与程序成功,未发生与手术相关的不良事件,术后Rutherford分级为0级2例（9.5%）,1级9例（42.8%）,2级3例（14.2%）,3级1例（4.7%）,4级3例（14.2%）,5级3例（14.2%）。1例（4.7%）术后9个月因冠心病而死亡,1例失访。18例随访至术后12个月时,ABI为0.69~1.45,平均0.84±0.12,一期通畅率为83.3%,免于临床驱动的靶病变血运重建率为88.9%。 结论：TurboHawk腔内减容联合DCB治疗复杂股腘动脉ISR安全有效,近期效果较为满意。     

股浅动脉长段闭塞的治疗

目的 分析研究常规球囊扩张与切割球囊相结合在股浅动脉长段闭塞治疗中的扩张效果和中期疗效.方法 2009年6月～2010年7月间应用常规球囊扩张联合切割球囊治疗51例动脉硬化闭塞症股浅动脉长段闭塞患者,观察其临床疗效.结果 51例患者中有49例导丝通过闭塞段,动脉直径狭窄率为35％～83％.治疗后患者重度狭窄部位的狭窄程度平均减少至37％,其他部位的狭窄程度减少至20％左右,未发生动脉壁撕裂,穿孔出血合并症.术后1年CTA复查有13％的患者再次出现闭塞,未闭塞的患者中动脉最狭窄处狭窄程度平均为55％.结论 常规长球囊与切割球囊相配合可以有效地治疗股浅动脉长段闭塞,中期效果较好,但长期疗效有待于进一步观察.     

Rotarex系统联合药物涂层球囊治疗股腘动脉长段支架内完全闭塞

目的观察减容装置Rotarex系统联合药物涂层球囊(DCB)治疗股腘动脉(FPA)长段支架内完全闭塞的效果。方法 29例(29肢)FPA长段(病变长度10 cm)支架内完全闭塞患者接受减容装置Rotarex联合DCB(紫杉醇)治疗;观察疗效及并发症,随访统计术后6、12个月一期通畅率和12个月避免靶血管重建(TLR)率。结果 29例治疗技术成功率为100%,无相关严重并发症;术后踝肱指数(ABI)较术前显著提高(t=-15.611,P0.001)。6个月一期通畅率为86.21%(25/29),12个月一期通畅率为72.41%(21/29);12个月避免TLR率为79.31%(23/29);12个月随访期间无死亡或截肢事件发生。结论 Rotarex系统联合DCB治疗FPA长段支架内完全闭塞安全、有效。