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因胆道支架侵蚀导致肝动脉假性动脉瘤栓塞后弹簧圈移位

Coil Migration After Embolization of Hepatic Artery Pseudoaneurysm Due to Biliary Stent Erosion.

作者信息

Edmunds Carter E, Duy Lindsay, Clark Clancy J, Pawa Rishi, Pawa Swati

机构信息

Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, USA.

Radiology, Atrium Health Wake Forest Baptist Medical Center, Winston-Salem, USA.

出版信息

Cureus. 2025 Jun 12;17(6):e85877. doi: 10.7759/cureus.85877. eCollection 2025 Jun.

Abstract

Coil embolization migration is a rare complication of transcatheter arterial embolization intervention. This report describes a 69-year-old male who experienced massive hematemesis due to an iatrogenic hepatic artery pseudoaneurysm caused by erosion from a metal biliary stent. His pseudoaneurysm was treated by coil embolization, initially with resolution of bleeding, but was later complicated by intra-abdominal infections in the setting of the coil migration into the gastrointestinal tract. Consequently, the coil was removed endoscopically with resolution of symptoms. Currently, there are no standardized guidelines for managing migrated coils; however, symptomatic cases often require intervention due to the risk of bleeding, perforation, or infection if not addressed. This case highlights the importance of monitoring patients after undergoing transcatheter arterial embolization and considering endoscopic removal as a practical management consideration.

摘要

弹簧圈栓塞移位是经导管动脉栓塞介入治疗的一种罕见并发症。本报告描述了一名69岁男性,因金属胆道支架侵蚀导致医源性肝动脉假性动脉瘤而出现大量呕血。他的假性动脉瘤通过弹簧圈栓塞治疗,最初出血得到缓解,但后来在弹簧圈移位至胃肠道的情况下并发腹腔感染。因此,通过内镜取出弹簧圈后症状得到缓解。目前,对于处理移位弹簧圈尚无标准化指南;然而,有症状的病例如果不加以处理,由于存在出血、穿孔或感染的风险,往往需要进行干预。该病例强调了对接受经导管动脉栓塞治疗的患者进行监测以及将内镜取出作为一种切实可行的管理方法的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d445/12163056/28b211aa032c/cureus-0017-00000085877-i01.jpg

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