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钝性或医源性肾创伤后动脉损伤的血管内治疗

Endovascular management of arterial injuries after blunt or iatrogenic renal trauma.

作者信息

Loffroy Romaric, Chevallier Olivier, Gehin Sophie, Midulla Marco, Berthod Pierre-Emmanuel, Galland Christophe, Briche Pascale, Duperron Céline, Majbri Nabil, Mousson Christiane, Falvo Nicolas

机构信息

1Department of Vascular and Interventional Radiology, 2Department of Urology and Andrology, 3Department of Nephrology and Renal Transplantation, François-Mitterrand Teaching Hospital, Dijon, France.

出版信息

Quant Imaging Med Surg. 2017 Aug;7(4):434-442. doi: 10.21037/qims.2017.08.04.

Abstract

The kidney is the third most common abdominal organ to be injured in trauma, following the spleen and liver, respectively. The most commonly used classification scheme is the American Association for the Surgery of Trauma (AAST) classification of blunt renal injuries, which grades renal injury according to the size of laceration and its proximity to the renal hilum. Arteriovenous fistula and pseudoaneurysm are the most common iatrogenic biopsy-related or surgery-related vascular injuries in native kidneys. The approach to renal artery injuries has changed over time from more aggressive intervention to more conservative observational or endovascular management, including selective transcatheter arterial embolization (TAE) and the placement of stents/stent grafts. In this article, we describe the role and technical aspects of endovascular interventions in the management of arterial injuries after blunt or iatrogenic renal trauma.

摘要

肾脏是创伤中第三常见的腹部受伤器官,仅次于脾脏和肝脏。最常用的分类方案是美国创伤外科学会(AAST)的钝性肾损伤分类,该分类根据撕裂伤的大小及其与肾门的距离对肾损伤进行分级。动静脉瘘和假性动脉瘤是天然肾脏中最常见的与医源性活检或手术相关的血管损伤。随着时间的推移,肾动脉损伤的治疗方法已从更积极的干预转变为更保守的观察或血管内治疗,包括选择性经导管动脉栓塞(TAE)以及支架/支架移植物的置入。在本文中,我们描述了血管内干预在钝性或医源性肾创伤后动脉损伤管理中的作用和技术方面。

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