经导管弹簧圈栓塞法治疗脾动脉瘤的临床疗效

目的:评估经导管腔内弹簧圈栓塞术治疗脾动脉瘤的安全性、可行性及疗效.方法:收集2008年3月-2010年9月我院9例脾动脉瘤患者,其中真性动脉瘤7例,假性动脉瘤2例.5例瘤体位于脾动脉中段,3例位于近段,1例接近脾门.所有患者均经CTA和(或)MRA确诊.其中6例真性动脉瘤采用经导管弹簧圈依次栓塞载瘤动脉远端、瘤腔和载瘤动脉近端；余3例栓塞载瘤动脉远端和近端.术后随访6-24个月.依据CT增强/CTA及术后临床表现评估栓塞疗效.结果:9例脾动脉瘤栓塞均获得成功,术后未出现严重并发症.1例患者有轻度脾梗死(面积约10％)；另1例患者术后12个月因肝癌恶化死亡.8例存活患者CT复查示瘤腔及脾动脉未再通,栓塞良好.结论:经导管弹簧圈栓塞瘤腔及载瘤动脉远近端治疗脾动脉瘤安全可行且效果良好.

Transcatheter Embolization with Spring Coils for the Treatment of Splenic Artery Aneurysms

Objective: To assess the safety,feasibility and effectiveness of transcatheter embolization with spring coils for the treatment of splenic artery aneurysms(SAAs).Methods: Nine patients collected in our hospital from March 2008 to September 2010,underwent the treatment of transcatheter embolization via spring coils.Seven SAAs were true-aneurysms and the remained 2 were pseudoaneurysms.The lesions were in the middle of the splenic artery(n=5),at the proximal site(n=3) and close to the splenic hilum(n=1).SAAs were confirmed in all cases by CTA and(or) MRA.Part of true-aneurysms(n=6) were occluded with coils in the distal artery of aneurysms,the aneurismal lumen and the proximal artery sequently,while the pseudoaneurysms(n=3) were done in the distal and proximal arteries.All patients were followed up for 6 to 24 months after the procedure.The post-embolization effects were evaluated according to the clinical manifestations and enhanced CT(or CTA).Results: All the SAAs(100%) were successfully occluded with spring coils.No serious complications occurred in the follow-up period.One patient manifested mild splenic infarction(about 10% of areas);another one died from the deterioration of hepatic cancer 12 months later.All live patients(n=8) had no occurrence of splenic artery re-canalization and the aneurysms never reshaped.Conclusion: Transcatheter embolization with spring coils is a safe and effective method for the treatment of SAAs,however,the long-term efficacy was needed to study further.