Pyra Krzysztof, Szmygin Maciej, Sojka Michał, Drelich-Zbroja Anna, Jargiełło Tomasz
Zakład Radiologii Zabiegowej i Neuroradiologii, Uniwersytet Medyczny w Lublinie.
Pol Przegl Chir. 2019 Nov 21;92(1):23-28. doi: 10.5604/01.3001.0013.5895.
With estimated prevalence of 1% of the general population, visceral artery aneurysms are not a frequent pathology, however, their rupture is a life-threatening occurrence with mortality rate ranging from 10% to 25%, up to 75% in case of pregnant women. Therefore, the identification and treatment of visceral artery aneurysms is of great importance in the prevention of early rupture.
To assess the effectiveness and safety of treatment of visceral artery aneurysms with various endovascular methods focusing on technical aspects, complications and long-term clinical outcome.
60 patients with visceral artery aneurysms were treated percutaneously. Various techniques were used: coiling (23), covered stents (15), thrombin (7), and other mixed techniques. Aneurysm characteristics, size and localization, procedural data, peri-procedural complications, technical success, 90- and 180-day clinical success and follow-up period (aneurysm exclusion, patency of the artery and complications) were prospectively analyzed.
The procedure was performed in 57 of 60 patients. In 56 of 57 patients aneurysms ware effectively excluded. The success rate was 93.3% (56 of 60 enrolled patients). Technical success after the intervention was 82.4%, after second 98.2%. Embolization with covered stents was characterized by the highest efficiency. Serious complications occurred in 1.8% of cases.
The minimally invasive endovascular treatment of visceral artery aneurysms is characterized by high efficacy and safety. Good treatment results depend on proper assessment of the aneurysm's morphology as well as on selection of the appropriate vascular approach and endovascular technique.
内脏动脉瘤在普通人群中的估计患病率为1%，并非常见病症，但其破裂会危及生命，死亡率在10%至25%之间，孕妇的死亡率高达75%。因此，内脏动脉瘤的识别和治疗对于预防早期破裂至关重要。
评估各种血管内治疗方法治疗内脏动脉瘤的有效性和安全性，重点关注技术方面、并发症和长期临床结果。
对60例内脏动脉瘤患者进行了经皮治疗。采用了多种技术：弹簧圈栓塞（23例）、覆膜支架置入（15例）、凝血酶注射（7例）以及其他混合技术。前瞻性分析了动脉瘤的特征、大小和位置、手术数据、围手术期并发症、技术成功率、90天和180天的临床成功率以及随访期（动脉瘤排除情况、动脉通畅情况和并发症）。
60例患者中有57例接受了手术。57例患者中的56例动脉瘤得到有效排除。成功率为93.3%（60例纳入患者中的56例）。干预后的技术成功率为82.4%，二次干预后为98.2%。覆膜支架栓塞的效率最高。严重并发症发生率为1.8%。
内脏动脉瘤的微创血管内治疗具有高效性和安全性。良好的治疗效果取决于对动脉瘤形态的正确评估以及合适血管入路和血管内技术的选择。
