血管内介入治疗腹腔内脏动脉瘤11例经验

目的评价介入治疗腹腔内脏动脉瘤的安全性和疗效。方法用介入技术治疗腹腔内脏动脉瘤11例,包括脾动脉瘤5例,胃-十二指肠动脉瘤5例,肠系膜上动脉(SMA)瘤1例。5例以假性动脉瘤破裂出血就诊,3例表现为上腹部疼痛和搏动性包块,3例无自觉症状。10例用血管内栓塞术,1例发自SMA的动脉瘤用联合动脉内栓塞和被覆膜支架置入术治疗。结果11例均治疗成功,无并发症。5例以出血为首发症状者,术后出血立即停止。1例SMA动脉瘤术后被完全封闭,主干及分支显影正常。3例术前有症状者术后腹痛逐渐消失、包块缩小。随访4～52个月(平均25.5个月),未发生与动脉瘤相关的并发症,超声波检查无动脉瘤复发表现。结论血管内介入技术是治疗腹腔内脏动脉瘤的安全有效方法。

Endovascular intervention for the treatment of visceral artery aneurysms: experience in 11 cases

Objective To evaluate interventional techniques for the management of splanchnic artery areurysms. MethodsThere were 11 cases including splenic artery aneurysm in 5 cases, gastroduodenal in 5, and superior mesenteric artery (SMA) aneurysm in 1. Five patients presented with ruptured pseudoaneurysms and bleeding. Three patients presented with abdominal pain and epigastric pulsatile mass. Three patients were asymptomatic. Transcatheter endovascular coil embolization was used in 10 patients. Combination of the endovascular embolization and stent-graft placement in the SMA was performed in 1 patient with SMA areurysm. ResultsTechnical success was achieved in all cases with no significant complications. Hemostasis was achieved in all 5 patients. One patient was cured by combination of stenting and endovascular coil embolization. An average follow-up of 25.5 months in 11 cases revealed no complications. Doppler ultrasound scan showed complete thrombosis and occlusion of these aneurysms. ConclusionsTranscatheter endovascular interventional techniques are safe and effective methods for the treatment of splanchnic artery areurysms.