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内脏动脉瘤和假性动脉瘤的血管内治疗。

Endovascular treatment of visceral aneurysms and pseudoaneurysms.

机构信息

Department of Vascular Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China.

Department of General Surgery, Qilu Hospital of Shandong University, Jinan, China.

出版信息

J Biol Regul Homeost Agents. 2021 Jan-Feb;35(1):131-140. doi: 10.23812/20-377-A.

Abstract

Visceral artery aneurysm (VAA) is a rare and potentially life-threatening condition, defined as true artery aneurysms and pseudoaneurysms of splanchnic circulation and renal artery. This study reports our experience in the diagnosis and endovascular treatment of visceral artery aneurysms (VAAs) over a 10-year period. Between 2008 and 2018, a total of 24 VAAs in 21 patients were diagnosed by clinical symptoms and a combination of imaging techniques, such as Doppler ultrasound, computed tomography angiogram, and catheter angiogram. All patients underwent endovascular treatment to exclude aneurysms. Oral antiplatelet medicine was administered, and imaging examination was performed during follow-up. Technical success was achieved in all 21 patients, and no periprocedural complications occurred. Endovascular coiling alone was employed in 10 aneurysms. Coiling was combined with gelfoam in 2 aneurysms. Coiling was assisted by stent in 4 aneurysms. Covered stents were deployed in 8 aneurysms individually. Clinical symptoms disappeared or highly improved in all patients after treatment. None of the patients showed recurrent symptoms after discharge. However, two cases with new aneurysms after 6 and 8 months, respectively, and one case with in-stent thrombosis after 12 months were reported during follow-up. This study may justify the efficacy of percutaneous endovascular coil embolization and stent deployment. It also provides beneficial experience about how to choose appropriate various endovascular strategies based on both clinical symptoms and aneurysm anatomy condition.

摘要

内脏动脉动脉瘤(VAA)是一种罕见且可能危及生命的疾病,定义为内脏循环和肾动脉的真性动脉瘤和假性动脉瘤。本研究报告了我们在 10 年期间诊断和血管内治疗内脏动脉动脉瘤(VAAs)的经验。在 2008 年至 2018 年期间,通过临床症状和多种影像学技术(如多普勒超声、计算机断层血管造影和导管血管造影)共诊断了 21 例患者的 24 个 VAA。所有患者均接受了血管内治疗以排除动脉瘤。给予口服抗血小板药物,并在随访期间进行影像学检查。21 例患者均获得技术成功,且无围手术期并发症发生。单独采用血管内弹簧圈栓塞治疗 10 个动脉瘤。2 个动脉瘤采用弹簧圈联合明胶海绵治疗。4 个动脉瘤采用支架辅助弹簧圈栓塞治疗。8 个动脉瘤单独采用覆膜支架治疗。治疗后所有患者的临床症状均消失或明显改善。出院后无患者出现复发症状。然而,在随访期间分别报告了 2 例在 6 个月和 8 个月后出现新动脉瘤,1 例在 12 个月后出现支架内血栓形成。本研究可能证明了经皮血管内弹簧圈栓塞和支架置入的疗效。它还提供了根据临床症状和动脉瘤解剖条件选择合适的各种血管内策略的有益经验。

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