Li Er-Sheng, Mu Ji-Xing, Ji Shuan-Meng, Li Xiao-Min, Xu Lan-Bin, Chai Tian-Chang, Liu Jun-Xiao
Er-Sheng Li, Ji-Xing Mu, Xiao-Min Li, Lan-Bin Xu, Tian-Chang Chai, Jun-Xiao Liu, Department of Radiology, The First Affiliated Hospital, Xingtai Medical College, Xingtai 054001, Hebei Province, China.
World J Gastroenterol. 2014 Jan 14;20(2):555-60. doi: 10.3748/wjg.v20.i2.555.
To evaluate total embolization of the main splenic artery in patients with splenic artery aneurysms (SAAs) and normal spleen.
Thirty-five consecutive patients with SAAs were referred for treatment with coil embolization. Patients were classified into two groups: coil embolization of the main splenic artery with complete occlusion of the artery and aneurysms (group A, n = 16), and coil embolization of the aneurysmal sac with patency of the splenic artery (group B, n = 19). Data on white blood cell (WBC) and platelet counts, liver function, and complications were collected on days 7 and 30, and subsequently at a 6-mo interval postoperatively. Abdominal computed tomography was routinely performed to calculate the splenic volume before and 1 mo after the procedure, and subsequently every 6 mo during follow-up.
Coil embolization of the SAAs was technically successful in all 35 patients, with no procedure-related complications. The post-embolization syndrome, including abdominal pain, fever and vomiting, occurred in six patients (37.5%) in group A and three patients in group B (15.8%). There were no significant differences in WBC and platelet counts between preoperatively and at each follow-up point after the procedures. There were also no significant differences in average WBC and platelet counts between the two groups at each follow-up point. There were significant differences in splenic volume in group A between preoperatively and at each follow-up point, and there were also significant differences in splenic volume between the two groups at each follow-up point.
Total embolization of the main splenic artery was a safe and feasible procedure for patients with SAAs and normal spleen.
评估脾动脉瘤(SAA)且脾脏正常的患者行脾动脉主干完全栓塞术的效果。
连续35例SAA患者接受弹簧圈栓塞治疗。患者分为两组:脾动脉主干弹簧圈栓塞且动脉与动脉瘤完全闭塞(A组,n = 16),以及动脉瘤囊弹簧圈栓塞且脾动脉通畅(B组,n = 19)。于第7天和第30天收集白细胞(WBC)和血小板计数、肝功能及并发症数据,术后每隔6个月收集一次。常规进行腹部计算机断层扫描以计算术前及术后1个月的脾体积,随后在随访期间每6个月计算一次。
35例患者的SAA弹簧圈栓塞技术均成功,无手术相关并发症。栓塞后综合征,包括腹痛、发热和呕吐,在A组6例患者(37.5%)和B组3例患者(15.8%)中出现。术前与术后各随访点的WBC和血小板计数无显著差异。两组在各随访点的平均WBC和血小板计数也无显著差异。A组术前与各随访点的脾体积有显著差异,两组在各随访点的脾体积也有显著差异。
对于SAA且脾脏正常的患者,脾动脉主干完全栓塞是一种安全可行的手术。