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介入放射科医生(萨米尔)序贯抽吸并注射明胶基止血剂与自体血凝块的混合物,随后进行缝合线圈植入以有效栓塞脾动脉假性动脉瘤:一种新技术的描述

Sequential Aspiration and injection of a Mixture of gelatin-based hemostatic agent and autologous blood clot followed by suture coiling for Effective Embolization of splenic artery pseudoaneurysm by interventional Radiologist (SAMEER): Description of a novel technique.

作者信息

Peer Sameer, Bajaj Manik, Bhagat Tamanna, Raina Rohit, Kaushal Gourav

机构信息

Department of Radiodiagnosis, All India Institute of Medical Sciences, Bathinda, Punjab 151001, India.

Department of General Medicine, All India Institute of Medical Sciences, Bathinda, Punjab 151001, India.

出版信息

Radiol Case Rep. 2025 Mar 29;20(6):3024-3030. doi: 10.1016/j.radcr.2025.03.006. eCollection 2025 Jun.

DOI:10.1016/j.radcr.2025.03.006
PMID:40230714
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11994322/
Abstract

Pseudoaneurysms of the splenic artery usually arise as a complication of pancreatitis. Due to the risk of rupture, treatment of the pseudoaneurysms of splenic artery is considered as a priority in the management of pancreatitis. While endovascular embolization is an established minimally invasive and effective technique for the treatment of splenic artery pseudoaneurysms, however, in some cases endovascular embolization may not be feasible, owing to the difficulties in accessing the distal small pseudoaneurysms or due to financial constraints. In such a scenario, percutaneous image guided direct puncture and embolization of the pseudoaneurysms is a valuable option. While most of the previous publications have reported on the use of n‑butyl cyanoacrylate, coils and thrombin for percutaneous embolization of splenic artery pseudoaneurysms, however, these agents may not be easily accessible to many health facilities in emergency situations and their cost may limit their use. In this report, we describe a novel technique of percutaneous embolization of splenic artery pseudoaneurysms with equential spiration and injection of a ixture of gelatin-based hemostatic agent and autologous blood clot followed by suture coiling for ffective mbolization of splenic artery pseudoaneurysm by interventional adiologist (SAMEER technique). We demonstrate the safety and efficacy of this technique in a series of 2 cases.

摘要

脾动脉假性动脉瘤通常作为胰腺炎的并发症出现。由于存在破裂风险,脾动脉假性动脉瘤的治疗被视为胰腺炎管理中的优先事项。虽然血管内栓塞是治疗脾动脉假性动脉瘤的一种既定的微创且有效技术,然而,在某些情况下,由于难以接近远端小假性动脉瘤或由于经济限制,血管内栓塞可能不可行。在这种情况下,经皮影像引导下直接穿刺并栓塞假性动脉瘤是一种有价值的选择。虽然之前的大多数出版物都报道了使用正丁基氰基丙烯酸酯、线圈和凝血酶进行脾动脉假性动脉瘤的经皮栓塞,然而,在紧急情况下,许多医疗机构可能难以轻易获得这些药物,并且它们的成本可能会限制其使用。在本报告中,我们描述了一种经皮栓塞脾动脉假性动脉瘤的新技术,即依次抽吸并注射基于明胶的止血剂和自体血凝块的混合物,随后进行缝合线圈,由介入放射科医生有效栓塞脾动脉假性动脉瘤(SAMEER技术)。我们在一系列2例病例中证明了该技术的安全性和有效性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/63be/11994322/75ee9333f804/gr5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/63be/11994322/991cc1cb5984/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/63be/11994322/035182cfc18d/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/63be/11994322/5d9feedd9fca/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/63be/11994322/ee766b92d5b7/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/63be/11994322/75ee9333f804/gr5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/63be/11994322/991cc1cb5984/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/63be/11994322/035182cfc18d/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/63be/11994322/5d9feedd9fca/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/63be/11994322/ee766b92d5b7/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/63be/11994322/75ee9333f804/gr5.jpg

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Pseudoaneurysms embolization with glue via percutaneous direct puncture: a multicenter experience on 54 patients.经皮直接穿刺用胶水栓塞假性动脉瘤:54例患者的多中心经验
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