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医源性血管损伤的血管内治疗回顾性研究。

A retrospective study on endovascular management of iatrogenic vascular injuries.

作者信息

Xiong Jiang, Liu Meng, Guo Wei, Liu Xiaoping, Yin Tai, Jia Xin, Wang Lijun, Ma Xiaohui, Zhang Hongpeng

机构信息

Department of Vascular Surgery, Clinical Division of Surgery, Chinese PLA General Hospital and Postgraduate Medical School, Beijing, People's Republic of China.

出版信息

Vascular. 2012 Apr;20(2):65-71. doi: 10.1258/vasc.2011.oa0327. Epub 2012 Apr 4.

DOI:10.1258/vasc.2011.oa0327
PMID:22490785
Abstract

The purpose of this study was to evaluate the outcome of endovascular management of iatrogenic vascular injuries (IVIs). We retrospectively reviewed the clinical records of 19 consecutive patients who underwent endovascular therapy of IVIs. Endograft implantation was conducted in 13 patients, intravascular embolization using coil was performed in four patients, combined treatment involving endovascular balloon intervention and percutaneous thrombin injection was done in one patient and the remaining one patient received balloon compression for hemostasis. There were no deaths after the operation. In the patients with vessel rupture (n = 9) or perforation (n = 4), cessation of bleeding and restoration of blood flow were achieved following the endovascular treatments. Four cases of pseudoaneurysm and one case of arteriovenous fistula were successfully eliminated. At a median follow-up of 23.8 months (range 4-84), one patient suffered a mild cerebral infarction secondary to covered stent placement and one patient developed a partial renal infarction secondary to coil embolization. Additionally, stent collapse was found in one patient with stenosis of the iliofemoral vein, accounting for the failure to resolve the lower limb edema. In conclusion, endovascular therapy is an effective technique in the management of different types of IVIs, but is associated with minor ischemic complications.

摘要

本研究的目的是评估医源性血管损伤(IVIs)的血管内治疗结果。我们回顾性分析了19例接受IVIs血管内治疗的连续患者的临床记录。13例患者进行了血管内支架植入,4例患者采用弹簧圈进行血管内栓塞,1例患者采用血管内球囊干预联合经皮凝血酶注射的联合治疗,其余1例患者接受球囊压迫止血。术后无死亡病例。在血管破裂(n = 9)或穿孔(n = 4)的患者中,血管内治疗后实现了出血停止和血流恢复。4例假性动脉瘤和1例动静脉瘘成功消除。在中位随访23.8个月(范围4 - 84个月)时,1例患者因覆膜支架置入继发轻度脑梗死,1例患者因弹簧圈栓塞继发部分肾梗死。此外,1例髂股静脉狭窄患者出现支架塌陷,导致下肢水肿未能缓解。总之,血管内治疗是治疗不同类型IVIs的有效技术,但伴有轻微的缺血性并发症。

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A retrospective study on endovascular management of iatrogenic vascular injuries.医源性血管损伤的血管内治疗回顾性研究。
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