Carriero Serena, Lanza Carolina, Biondetti Pierpaolo, Renzulli Matteo, Bonelli Cristian, Piacentino Filippo, Fontana Federico, Venturini Massimo, Carrafiello Gianpaolo, Ierardi Anna Maria
Postgraduate School of Radiodiagnostics, Università degli Studi di Milano, 20122 Milan, Italy.
Interventional Radiology Unit, Department of Radiology, Foundation IRCCS Ca' Granda-Ospedale Maggiore Policlinico, 20122 Milan, Italy.
J Clin Med. 2022 May 24;11(11):2952. doi: 10.3390/jcm11112952.
Visceral artery pseudoaneurysms (VAPAs) are the most frequently diagnosed pseudoaneurysms (PSAs). PSAs can be asymptomatic or symptomatic. The aim of our study was to evaluate the safety and effectiveness of percutaneous embolization of VAPAs performed on patients with an unfeasible trans-arterial approach. Fifteen patients with fifteen visceral PSAs, with a median dimension of 21 mm (IQR 20-24 mm), were retrospectively analyzed. No patients were suitable for trans-arterial catheterization and therefore a percutaneous approach was chosen. During percutaneous treatments, two embolic agents were used, either N-butyl cyanoacrylate (NBCA) (Glubran II, GEM Milan, Italy) mixed with Lipiodol (Lipiodol, Guerbet, France) or thrombin. The outcomes of this study were technical success, primary clinical success, and secondary clinical success. In our population the 15 PSA were located as follows: 2 in the left gastric artery, 1 in the right gastric artery, 3 in the right hepatic artery, 2 in a jejunal artery, 1 in left colic artery branch, 1 in a right colic artery branch, 1 in the gastroepiploic artery, 1 in the dorsal pancreatic artery, 1 in an ileocolic artery branch, 1 in an iliac artery branch, and 1 in a sigmoid artery branch. 80% of PSAs (12/15) were treated with a NBCA:lipiodol mixture and 20% of PSAs (3/15) were treated with thrombin. Technical, primary, and secondary clinical successes were obtained in 100% of the cases. No harmful or life-threatening complications were observed. Minor complications were registered in 26.6% (4/15) of the patients. Percutaneous embolization of visceral PSA is a safe and effective treatment and should be considered as an option when the endovascular approach is unsuccessful or unfeasible.
内脏动脉假性动脉瘤（VAPA）是最常被诊断出的假性动脉瘤（PSA）。PSA可以无症状或有症状。我们研究的目的是评估对经动脉途径不可行的患者进行经皮栓塞治疗VAPA的安全性和有效性。对15例患有15个内脏PSA的患者进行了回顾性分析，这些PSA的中位尺寸为21毫米（四分位间距20 - 24毫米）。没有患者适合经动脉导管插入术，因此选择了经皮途径。在经皮治疗过程中，使用了两种栓塞剂，即与碘油（法国Guerbet公司的碘油）混合的氰基丙烯酸正丁酯（NBCA）（意大利GEM米兰公司的Glubran II）或凝血酶。本研究的结果包括技术成功、初次临床成功和二次临床成功。在我们的研究对象中，15个PSA的位置如下：胃左动脉2个，胃右动脉1个，肝右动脉3个，空肠动脉2个，左结肠动脉分支1个，右结肠动脉分支1个，胃网膜动脉1个，胰背动脉1个，回结肠动脉分支1个，髂动脉分支1个，乙状结肠动脉分支1个。80%的PSA（12/15）用NBCA:碘油混合物治疗，20%的PSA（3/15）用凝血酶治疗。所有病例均获得了技术、初次和二次临床成功。未观察到有害或危及生命的并发症。26.6%（4/15）的患者出现了轻微并发症。内脏PSA的经皮栓塞是一种安全有效的治疗方法，当血管内治疗不成功或不可行时应将其视为一种选择。
