血管内栓塞治疗15例假性动脉瘤

目的 回顾近十年来收治的15例假性动脉瘤，分析其发病机理、临床表现、影像学特点及治疗方法。方法 15例病人中男9例，女6例，平均年龄43．9岁（9－57岁）。外伤性9例，夹层所致4例，手术所致2例。颈内动脉11例，椎3例，颈外动脉1例。外伤性颈内动脉海绵窦瘘（TCCF）合并假性动脉瘤4例。影像学特点清嵝不位于血管分叉处，形状不规则，瘤底部常用“小壶”影。全部病例均采用局麻下经股动脉或颈动脉Seldinger′s穿刺，在系统抗凝情况下栓塞动脉瘤。结果 15例假性动脉瘤中保留载瘤动脉4例。全部病例栓塞后动脉瘤均消失。半年后血管造影随访复查未见动态瘤复发。结论 血管内栓塞是治疗假性动脉瘤的有效而首选的方法。

Endovascular Treatment of Pseudoaneurysms (Clinical analysis of 15 cases)

Objective To explore the pathogenesis, clinical manifestations and angiographic features of pseudoaneurysms. Methods Of the 15 patients with pseudonaeurysms, 9 were caused by traumas, 4 by dissecting aneurysm and 2 by surgery. Eleven located in the internal carotid artery, three in the vertebral artery, one in the external carotid artery. The pseudoaneurysms were accompanied with traumatic carotid-cavernous fistulas (TCCF) in 4 cases. All the patients were treated with endova-scular embolizing techniques. Results The pseudoaneurysms were embolized but their parent vessels were preserved in 4 cases. The parent vessels were embolized in 7 cases. The TCCF and pseudoaneurysms were closed with balloons and coils, but their parent arteries was intact. All the pseudoaneurysms were disappeared after embolization. There were no recurrences during half a year follow-up period. Conclusion The endovascular treatment is an effective and optimum method of treating the pseudoaneurysms.