Tahir Muhammad Misbah
Department of Radiology, Aga Khan University Hospital, Karachi, Pakistan.
J Pak Med Assoc. 2012 May;62(5):470-3.
To evaluate retrospectively the results, complications and follow-up of patients after endovascular treatment of vascular injuries.
Fifty transcatheter embolisation procedures (TCE) were performed in 46 patients between 1999 and 2008 at the Aga Khan University Hospital, Karachi. Injuries in 14 (30.4%) patients were due to road traffic accident; iatrogenic in 13 (28%); accidental in 6 (13%). Firearms, bomb blasts and earthquake contributed to injuries in 8(17%), 4(8.8%) and 1(2.2%) patients respectively. All patients underwent angiography and had evidence of either active haemorrhage, pseudo-aneurysm, abnormal vascularity or arteriovenous fistula. Followup ranged from 1 day to 6 years with mean of 10.5 months. Medical record files, lab results and imaging reports were utilised for the study. Procedure was declared as technically successful when there was cessation of extravasation, occlusion of fistula or exclusion of pseudo-aneurysm in the post-embolisation angiograms. Treatment was deemed clinically successful if there was resolution of the indication for which the procedure was done.
Transcatheter embolisation was technically successful in occluding vascular lesions in all 46 (100%) patients. Lesions recurred in 4 (9%) patients who underwent initially successful TCE. These patients were treated effectively with repeated TCE. Three patients died during the same hospital stay and 3 patients died after being discharged from the hospital. All these patients were treated successfully with TCE and had factors other then TCE contributing to their mortality.
Transcatheter embolisation for vascular injuries was found to be a satisfactory procedure, with low morbidity and mortality rates.
回顾性评估血管损伤血管内治疗患者的治疗结果、并发症及随访情况。
1999年至2008年期间，在卡拉奇阿迦汗大学医院对46例患者进行了50次经导管栓塞术（TCE）。14例（30.4%）患者的损伤由道路交通事故所致；13例（28%）为医源性损伤；6例（13%）为意外损伤。火器伤、炸弹爆炸和地震分别导致8例（17%）、4例（8.8%）和1例（2.2%）患者受伤。所有患者均接受了血管造影，并有活动性出血、假性动脉瘤、异常血管或动静脉瘘的证据。随访时间为1天至6年，平均为10.5个月。研究使用了病历档案、实验室检查结果和影像学报告。如果栓塞后血管造影显示外渗停止、瘘管闭塞或假性动脉瘤排除，则该手术在技术上被判定为成功。如果手术指征得到解决，则认为治疗在临床上是成功的。
经导管栓塞术在所有46例（100%）患者中成功闭塞了血管病变。4例（9%）最初TCE成功的患者出现病变复发。这些患者通过重复TCE得到有效治疗。3例患者在同一住院期间死亡，3例患者在出院后死亡。所有这些患者的TCE治疗均成功，其死亡有TCE以外的其他因素。
经导管栓塞术治疗血管损伤是一种令人满意的手术，发病率和死亡率较低。
