Department of Radiodiagnosis, PGIMER, Chandigarh, India.
Department of Radiodiagnosis, PGIMER, Chandigarh, India.
Clin Radiol. 2021 Apr;76(4):314.e17-314.e23. doi: 10.1016/j.crad.2020.12.016. Epub 2021 Jan 30.
To analyse the technical challenges, clinical success, and associated complications of endovascular and percutaneous embolisation of pancreatitis-related pseudoaneurysms.
A retrospective study of patients referred for embolisation of pancreatitis-related pseudoaneurysms between January 2014 and March 2019 was conducted. Computed tomography angiography (CTA) was performed to assess the morphology of the aneurysms prior to any intervention. Percutaneous or endovascular embolisation was performed. Details of CTA and methods of embolisation were recorded. Technical success, clinical success, and complications were reported.
A total of 80 patients (mean age, 40.69 ± 13.41 years, 73 male) underwent embolisation during the study period. Pseudoaneurysms were related to chronic pancreatitis (CP) in 44 (55%) patients and acute pancreatitis (AP) in 36 (45%) patients. Pseudoaneurysms were detected in 65 (81.2%) patients on CTA. The most common site of pseudoaneurysms was gastroduodenal artery (GDA) followed by splenic artery. Seven patients were treated with percutaneous thrombin injection and five were treated with percutaneous glue injection under ultrasound/fluoroscopy guidance. The remaining patients (n=68) underwent catheter angiography with endovascular embolisation. Technical success was achieved in 4/7 (57%) percutaneous thrombin cases and in all the cases (5/5, 100%) with percutaneous glue or endovascular (68/68,100%) embolisation.
Endovascular or percutaneous embolisation of pseudoaneurysms has high technical success with an excellent safety profile.
分析胰腺炎相关假性动脉瘤血管内和经皮栓塞的技术挑战、临床成功率及相关并发症。
对 2014 年 1 月至 2019 年 3 月期间因胰腺炎相关假性动脉瘤而接受栓塞治疗的患者进行回顾性研究。在进行任何干预之前，均通过计算机断层扫描血管造影（CTA）评估动脉瘤的形态。进行经皮或血管内栓塞。记录 CTA 细节和栓塞方法。报告技术成功率、临床成功率和并发症。
在研究期间，共有 80 例患者（平均年龄为 40.69±13.41 岁，73 例男性）接受了栓塞治疗。假性动脉瘤与慢性胰腺炎（CP）相关的有 44 例（55%），与急性胰腺炎（AP）相关的有 36 例（45%）。65 例（81.2%）患者通过 CTA 检测到假性动脉瘤。假性动脉瘤最常见的部位是胃十二指肠动脉（GDA），其次是脾动脉。7 例患者接受经皮凝血酶注射治疗，5 例患者接受超声/透视引导下经皮胶注射治疗。其余患者（n=68）接受导管血管造影术和血管内栓塞治疗。在 7 例经皮凝血酶注射治疗中，技术成功率为 4/7（57%），在所有经皮胶或血管内（68/68，100%）栓塞治疗中，技术成功率均为 5/5（100%）。
假性动脉瘤的血管内或经皮栓塞具有很高的技术成功率，且安全性良好。
