微弹簧圈栓塞治疗下肢创伤性假性动脉瘤

目的评估微弹簧圈栓塞治疗下肢创伤性假性动脉瘤(TPA)的有效性和安全性。方法回顾性分析2016年4月至2018年6月南京中大医院采用微弹簧圈栓塞治疗的4例下肢TPA患者临床资料。术前CTA和术中DSA造影评估TPA形态学特征、载瘤动脉解剖特点及侧支循环情况,术中造影明确诊断后以微弹簧圈栓塞载瘤动脉和瘤体。术后复查CTA评估瘤体栓塞效果,TPA有无复发,弹簧圈有无移位,随访观察患者临床症状、体征改善情况及有无并发症发生。结果4例患者下肢TPA均经术前CTA和术中造影明确诊断,瘤体栓塞术均获成功,术后即刻复查造影见瘤体消失,未见弹簧圈异位栓塞。术后患者症状、体征明显改善,无并发症出现,随访复查CTA均未见假性动脉瘤复发。结论微弹簧圈栓塞治疗下肢TPA患者安全有效,优势明显,可作为优选栓塞材料。

Microcoil embolization for the treatment of traumatic pseudoaneurysm of lower extremity

Objective To evaluate the efficacy and safety of microcoil embolization in the treatment of traumatic pseudoaneurysm(TPA)of lower extremity.Methods The clinical data of 4 patients with TPA of lower extremity,who were admitted to Nanjing Zhongda Hospital of China during the period from April 2016 to June 2018 to receive microcoil embolization therapy,were retrospectively analyzed.Preoperative CTA and intraoperative angiography were performed to evaluate the morphological characteristics of TPA,the anatomical characteristics of the parent artery and the collateral circulation.After the diagnosis was confirmed by intraoperative angiography,embolization with microcoils to occlude the parent artery and the pseudoaneurysm cavity was carried out.Postoperative CTA was performed to evaluate the embolization effect for pseudoaneurysm and to detect the recurrence of TPA and the shifting of microcoil.The patients were followed up to observe the improvement of clinical symptoms and signs,and the postoperative complications were recorded.Results Preoperative CTA and intraopertaive angiography confirmed the diagnosis of TPA in all 4 patients.Successful embolization of pseudoaneurysm cavity was accomplished in all 4 patients.Angiography performed immediately after embolization showed that previous pseudoaneurysm disappeared and no ectopic embolism by coil was seen.After treatment,the symptoms and signs of the patients were significantly improved and no complications occurred.No recurrence of pseudoaneurysm was found on followup CT angiography.Conclusion For the treatment of TPA of lower extremity,microcoil embolization is safe and effective.This therapy has obvious advantages,and microcoil can be used as preferred embolic material.