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经导管动脉栓塞术治疗肝包膜下血肿

Transcatheter arterial embolization for subcapsular hematoma of the liver.

作者信息

Onishi Yasuyuki, Shimizu Hironori, Oka Shojiro, Taniguchi Takanori, Kawahara Seiya, Ishisaka Yukio, Isoda Hiroyoshi, Nakamoto Yuji

机构信息

Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoin-Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan.

Department of Diagnostic Radiology, Kobe City Medical Center General Hospital, Kobe, Japan.

出版信息

Abdom Radiol (NY). 2023 Feb;48(2):765-772. doi: 10.1007/s00261-022-03732-w. Epub 2022 Nov 15.

Abstract

PURPOSE

This study aimed to evaluate the technical and clinical success rates of transcatheter arterial embolization (TAE) for subcapsular hematoma of the liver.

METHODS

Between January 2010 and March 2022, 34 patients underwent TAE for subcapsular hematomas of the liver. The causes of subcapsular hematoma were liver tumor rupture (n = 12), trauma (n = 12), iatrogenic complications (n = 9), and spontaneous bleeding (n = 1). The technical and clinical success rates of TAE, blood test results after TAE and additional treatments were evaluated. The patients were divided into either with or without retrograde segmental or lobar portal venous flow on angiography. Technical and clinical success rates and blood test results after TAE were compared between the two groups.

RESULTS

Technical and clinical success rates were 94.1% and 73.5%, respectively. Six patients died within one month of TAE. A repeat TAE was performed in three patients. Surgical removal and hemostasis for subcapsular hematoma were done in four patients. One patient had liver failure. The retrograde portal venous flow was observed in 18 patients. The difference in technical and clinical success rates and blood test results after TAE between the two groups was statistically insignificant.

CONCLUSION

TAE is an effective and safe treatment for subcapsular hematomas of the liver. The success rates of TAE and liver damage due to TAE did not differ between patients with and without retrograde portal venous flow.

摘要

目的

本研究旨在评估经导管动脉栓塞术(TAE)治疗肝包膜下血肿的技术成功率和临床成功率。

方法

2010年1月至2022年3月期间,34例患者接受了TAE治疗肝包膜下血肿。肝包膜下血肿的病因包括肝肿瘤破裂(n = 12)、创伤(n = 12)、医源性并发症(n = 9)和自发性出血(n = 1)。评估了TAE的技术成功率和临床成功率、TAE后的血液检查结果以及额外治疗情况。根据血管造影时有无逆行节段性或叶性门静脉血流将患者分为两组。比较两组TAE后的技术成功率、临床成功率和血液检查结果。

结果

技术成功率和临床成功率分别为94.1%和73.5%。6例患者在TAE后1个月内死亡。3例患者进行了重复TAE。4例患者进行了肝包膜下血肿的手术切除和止血。1例患者出现肝衰竭。18例患者观察到逆行门静脉血流。两组TAE后的技术成功率、临床成功率和血液检查结果差异无统计学意义。

结论

TAE是治疗肝包膜下血肿的一种有效且安全的方法。有无逆行门静脉血流的患者TAE的成功率及TAE所致肝损伤无差异。

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