使用基于乙烯-乙烯醇(EVOH)共聚物的非粘性液体栓塞剂(NALEAs)对内脏动脉假性动脉瘤进行血管内治疗。
Endovascular Treatment of Visceral Artery Pseudoaneurysms with Ethylene-Vinyl Alcohol (EVOH) Copolymer-Based Non-Adhesive Liquid Embolic Agents (NALEAs).
作者信息
Minici Roberto, Guerriero Pasquale, Fontana Federico, Venturini Massimo, Guzzardi Giuseppe, Piacentino Filippo, Coppola Andrea, Spinetta Marco, Siciliano Agostino, Serra Raffaele, Costa Davide, Ielapi Nicola, Santoro Rita, Brunese Luca, Laganà Domenico
机构信息
Radiology Unit, Dulbecco University Hospital, 88100 Catanzaro, Italy.
Department of Medicine and Health Sciences, University of Molise, 86100 Campobasso, Italy.
出版信息
Medicina (Kaunas). 2023 Sep 6;59(9):1606. doi: 10.3390/medicina59091606.
: Treatment of visceral artery pseudoaneurysms (VAPs) is always indicated regardless of their diameters, as their risk of rupture is significantly higher than that of visceral artery aneurysms. The invasiveness of surgery and its associated complications have led to a shift in favor of radiological interventions as the initial treatment of choice. However, there are still some unanswered questions on endovascular treatment of VAPs regarding the optimal endovascular technique and the efficacy and safety outcomes. The purpose of this multicenter study was to retrospectively evaluate the effectiveness and safety of endovascular treatment of visceral pseudoaneurysms using Ethylene-Vinyl Alcohol (EVOH) Copolymer-Based Non-Adhesive Liquid Embolic Agents (NALEAs). : Consecutive patients who underwent endovascular embolization with EVOH-based NALEAs for visceral artery pseudoaneurysms between January 2018 and June 2023 were retrospectively evaluated. : 38 embolizations were performed. Technical success was achieved in all patients. The clinical success rate was high (92.1% overall), with no significant differences between ruptured and unruptured VAPs ( = 0.679). Seven patients (18.4%) experienced procedure-related complications, related to one case of non-target embolization, four splenic abscesses due to end-organ infarction, and two femoral pseudoaneurysms. The rates of procedure-related complications, end-organ infarction, and vascular access-site complications did not significantly differ between ruptured and unruptured VAPs ( > 0.05). : Both ruptured and unruptured visceral pseudoaneurysms can be effectively and safely treated with NALEA-based endovascular embolization. We suggest considering the use of NALEAs, particularly in specific clinical cases that highlight their advantages, including patients with coagulopathy, fragile vessels, and embolization targets that are located at a considerable distance from the microcatheter tip and are otherwise difficult to reach.
无论内脏动脉假性动脉瘤(VAPs)的直径大小,均应进行治疗,因为其破裂风险显著高于内脏动脉瘤。手术的侵入性及其相关并发症促使治疗方式转向以放射介入作为首选的初始治疗方法。然而,关于VAPs的血管内治疗,在最佳血管内技术以及疗效和安全性结果方面仍存在一些未解决的问题。这项多中心研究的目的是回顾性评估使用基于乙烯 - 乙烯醇(EVOH)共聚物的非粘性液体栓塞剂(NALEAs)进行内脏假性动脉瘤血管内治疗的有效性和安全性。:对2018年1月至2023年6月期间使用基于EVOH的NALEAs对内脏动脉假性动脉瘤进行血管内栓塞的连续患者进行回顾性评估。:共进行了38次栓塞。所有患者均取得技术成功。临床成功率较高(总体为92.1%),破裂和未破裂的VAPs之间无显著差异( = 0.679)。7例患者(18.4%)出现与手术相关的并发症,包括1例非靶栓塞、4例因终末器官梗死导致的脾脓肿以及2例股动脉假性动脉瘤。破裂和未破裂的VAPs在手术相关并发症、终末器官梗死和血管穿刺部位并发症的发生率方面无显著差异( > 0.05)。:破裂和未破裂的内脏假性动脉瘤均可通过基于NALEAs的血管内栓塞进行有效且安全的治疗。我们建议考虑使用NALEAs,特别是在突出其优势的特定临床病例中,包括患有凝血病、血管脆弱的患者,以及栓塞靶点距离微导管尖端较远且难以到达的情况。