外周血管假性动脉瘤的介入治疗

目的 介绍不同类型外周血管假性动脉瘤的不同治疗方法。方法 13例假性动脉瘤，3例终末型动脉的假性动脉瘤采用明胶海绵进行栓塞，其中1例巨大血肿伴假性动脉瘤经栓塞后作手术血肿清除加动脉结扎术进行治疗；1例支干型假性动脉瘤采用两端弹簧圈栓塞；9例主干性外周动脉假性动脉瘤采用覆膜支架隔绝术。结果 所有假瘤均完全闭合，置人覆膜支架者其远端动脉搏动均正常。1例患者由于其他特殊原因，致穿刺部位又出现假性动脉瘤。其他患者无明显并发症。结论 采用介入技术可使各种外周血管假性动脉瘤得到有效治疗，多数情况下可以代替外科治疗。

Percutaneous intraarterial therapy of peripheral pseudoaneurysm

Objective To introduce the therapeutic choices for different types of peripheral pseudoaneurysms. Methods Peripheral pseudoaneurysm was interventionaUy treated in 13 patients. Intraarterial embolization was performed with gelfoam in 2 patients with terminal type. Elimination of hematoma and ligature of artery were surgically done following embolization in a patient with huge hematoma and pseudoaneurysm. Arterial segment proximal and distal to pseudoaneurysm in branch of deep femoral artery were respectivelly embolized with metallic coils in a patient. Endovascular covered stent graft was inserted for separation of pseudoaneurysm in 9 patients with trunk type. Results Pseudoaneurysm kept closed after treatment in all 13 patients. Distal arterial pulse was normal in 9 patients treated with stent graft. A new pseudoaneurysm presented as a complication at puncture site in 1 patient due to other factors. There were no other symptomatic complications. Conclusion Peripheral pseudoaneurysms can be effectively treated with interventional techniques instead of surgical operation.