Nicholson Anthony A, Patel Jai, McPherson Simon, Shaw David R, Kessel David
Radiology Department, Leeds Teaching Hospitals, Great George Street, Leeds LS1 3EX, United Kingdom.
J Vasc Interv Radiol. 2006 Aug;17(8):1279-85. doi: 10.1097/01.RVI.0000231948.08617.04.
To describe a 10-year experience of endovascular and percutaneous treatment of aneurysms and pseudoaneurysms complicating pancreatitis, and to analyze this experience and propose a classification based on computed tomography (CT) and angiographic findings that has therapeutic implications. This may reduce the rate of recurrent bleeding after surgery or endovascular treatment.
Twenty-three patients with aneurysms or pseudoaneurysms associated with acute pancreatitis were treated by endovascular or percutaneous methods. All underwent CT and angiography. The early development of a simple classification based on the CT and angiographic findings was used to guide treatment decisions. In accordance with this classification, 19 patients were treated by primary coil embolization and four were treated by primary percutaneous thrombin injection.
Among the 19 patients treated by primary coil embolization, there were two early recurrences of the pseudoaneurysm. All four patients treated by percutaneous thrombin injection exhibited late recurrences and were successfully treated by percutaneous thrombin injections. Twenty-one patients (91.3%) were alive at 6 months.
Endovascular and percutaneous treatment of aneurysms and pseudoaneurysms complicating pancreatitis is safe and effective and is associated with good outcomes, but careful follow-up is necessary. The decision of which treatment option is most appropriate can be made in accordance with a classification based on CT and angiographic appearance.
描述对胰腺炎并发动脉瘤和假性动脉瘤进行血管内及经皮治疗的10年经验，分析该经验并基于计算机断层扫描（CT）和血管造影结果提出一种具有治疗意义的分类方法。这可能会降低手术或血管内治疗后复发出血的发生率。
23例患有与急性胰腺炎相关的动脉瘤或假性动脉瘤的患者接受了血管内或经皮治疗。所有患者均接受了CT和血管造影检查。基于CT和血管造影结果早期制定的一种简单分类方法用于指导治疗决策。根据该分类，19例患者接受了初次弹簧圈栓塞治疗，4例患者接受了初次经皮注射凝血酶治疗。
在19例接受初次弹簧圈栓塞治疗的患者中，有2例假性动脉瘤早期复发。所有4例接受经皮注射凝血酶治疗的患者均出现晚期复发，并通过经皮注射凝血酶成功治疗。21例患者（91.3%）在6个月时存活。
对胰腺炎并发的动脉瘤和假性动脉瘤进行血管内及经皮治疗是安全有效的，且预后良好，但需要仔细随访。可根据基于CT和血管造影表现的分类来决定哪种治疗方案最合适。
