Department of Radiology Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
Diagn Interv Radiol. 2013 Sep-Oct;19(5):423-6. doi: 10.5152/dir.2013.13063.
We aimed to evaluate the feasibility and safety of selective arterial embolization for refractory knee hemarthrosis.
Transcatheter arterial embolization for refractory knee hemarthrosis was performed on five female patients (median age, 77 years; range, 71-80 years) between May 2009 and September 2012. Selective arterial embolization of the feeding artery was performed using a 2.5 F microcatheter coaxially advanced from a 5 F catheter with its tip positioned in the superficial femoral artery. One- or two-millimeter gelatin particles were used as embolic agents.
In all patients, transarterial embolization performed successfully after arteriography showed nontumorous staining around the knee joint. The feeding arteries were the lateral superior genicular artery in all five patients, the lateral inferior genicular artery in four patients, the medial superior genicular artery in one patient, the medial inferior genicular artery in one patient, the middle genicular artery in one patient, and the descending genicular artery in one patient. In all five patients, staining was remarkably diminished around the knee joint after the embolization procedure. No complication was observed. The hemarthrosis improved after the embolization, and the postoperative course has been uneventful with no recurrence in any patient.
These results suggest that selective arterial embolization for refractory hemarthrosis of the knee is safe and useful.
评估选择性动脉栓塞治疗膝关节顽固性关节积血的可行性和安全性。
2009 年 5 月至 2012 年 9 月，对 5 例女性患者（中位年龄 77 岁；范围，71-80 岁）进行了经导管动脉栓塞治疗膝关节顽固性关节积血。使用 2.5 F 微导管同轴推进 5 F 导管，将尖端置于股浅动脉内，对供血动脉进行选择性动脉栓塞。使用 1-2 毫米明胶颗粒作为栓塞剂。
所有患者在动脉造影显示膝关节周围非肿瘤染色后，均成功进行了经动脉栓塞治疗。5 例患者的供血动脉均为外侧上膝动脉，4 例患者为外侧下膝动脉，1 例患者为内侧上膝动脉，1 例患者为内侧下膝动脉，1 例患者为中间膝动脉，1 例患者为下行膝动脉。所有 5 例患者在栓塞术后膝关节周围的染色明显减少。未观察到并发症。关节积血在栓塞后得到改善，术后过程顺利，无任何患者复发。
这些结果表明，选择性动脉栓塞治疗膝关节顽固性关节积血是安全且有效的。
