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内脏动脉假性动脉瘤的临床特征、治疗及预后:三级医院的5年经验

Clinical Profile, Management, and Outcome of Visceral Artery Pseudoaneurysms: 5-Year Experience in a Tertiary Care Hospital.

作者信息

Shera Faiz Altaf, Shera Tahleel Altaf, Choh Naseer Ahmad, Bhat Mudasir H, Shah Omair Ashraf, Shaheen Feroze A, Robbani Irfan, Gojwari Tariq

机构信息

Department of Radio-diagnosis and Imaging, Sher-i-Kashmir Institute of Medical Sciences (SKIMS), Srinagar, Jammu & Kashmir, India.

出版信息

Int J Angiol. 2023 Feb 13;32(2):113-120. doi: 10.1055/s-0043-1761292. eCollection 2023 Jun.

Abstract

Visceral artery pseudoaneurysms are potentially lethal lesions and tend to rupture in a high proportion of cases, thereby warranting an immediate and active intervention. We present our experience of splanchnic visceral artery pseudoaneurysms in a university hospital over a 5-year time interval with emphasis on etiology, clinical presentation, management (endovascular/surgical), and final outcome. This was a retrospective study in which we searched our image database for pseudoaneurysms of visceral arteries over a period of 5 years. The clinical and operative details were retrieved from the medical record section of our hospital. The lesions were analyzed for the vessel of origin, size, etiology, clinical features, mode of treatment, and outcome. Twenty-seven patients with pseudoaneurysms were encountered. Pancreatitis (8) was the most common cause, followed by previous surgery (7) and trauma (6). Fifteen were managed by the interventional radiology (IR) team, 6 by surgery, and in 6 no intervention was done. Technical and clinical success was achieved in all patients in the IR group with few minor complications. Surgery and no intervention carry a high mortality in such a setting (66 and 50%, respectively). Visceral pseudoaneurysms are potentially fatal lesions, commonly encountered after trauma, pancreatitis, surgeries, and interventional procedures. These lesions are easily salvageable by minimally invasive interventional techniques (endovascular embolotherapy), and surgeries carry a lot of morbidity and mortality in such cases and a prolonged hospital stay.

摘要

内脏动脉假性动脉瘤是具有潜在致命性的病变,在很大比例的病例中容易破裂,因此需要立即进行积极干预。我们介绍了在一所大学医院5年时间里内脏动脉假性动脉瘤的治疗经验,重点是病因、临床表现、治疗方法(血管内/手术)及最终结果。这是一项回顾性研究,我们在影像数据库中搜索了5年内的内脏动脉假性动脉瘤。临床和手术细节从我院病历科室获取。对病变的起源血管、大小、病因、临床特征、治疗方式及结果进行了分析。共发现27例假性动脉瘤患者。胰腺炎(8例)是最常见病因,其次是既往手术史(7例)和外伤(6例)。15例由介入放射学(IR)团队治疗,6例接受手术治疗,6例未进行干预。IR组所有患者均取得技术和临床成功,仅有少数轻微并发症。在这种情况下,手术治疗和不进行干预的死亡率很高(分别为66%和50%)。内脏假性动脉瘤是潜在致命性病变,常见于外伤、胰腺炎、手术及介入操作后。这些病变可通过微创介入技术(血管内栓塞治疗)轻松挽救,而在此类病例中手术治疗存在较多并发症和死亡率,且住院时间延长。

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