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经动脉微栓塞治疗慢性静脉溃疡患者微动静脉瘘后发生的严重并发症：一例报告

Severe complications following transarterial microembolization for a micro arterio-venous fistula in a patient with chronic venous ulcer: a case report.

作者信息

Boonlorm Wankarn, Nisityotakul Panat

机构信息

Department of Radiology, Vachira Phuket Hospital, Phuket, Thailand.

出版信息

Front Radiol. 2025 Jul 18;5:1613940. doi: 10.3389/fradi.2025.1613940. eCollection 2025.

DOI:10.3389/fradi.2025.1613940
PMID:40756785
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12313676/
Abstract

Transarterial microembolization (TAME) has gained recognition as a minimally invasive treatment for chronic musculoskeletal pain, demonstrating significant efficacy with a favorable safety profile ( 1, 2). However, complications remain underreported. This case report describes the first documented severe adverse event in a patient with a chronic venous ulcer undergoing TAME for a micro arteriovenous fistula (AVF). The patient developed significant complications, including extensive leg swelling, skin changes, and cellulitis requiring prolonged inpatient care. These findings highlight the importance of patient selection and embolic agent considerations to mitigate potential risks associated with TAME.

摘要

经动脉微栓塞术（TAME）已被公认为是一种治疗慢性肌肉骨骼疼痛的微创方法，显示出显著疗效且安全性良好（1,2）。然而，并发症的报告仍然不足。本病例报告描述了首例有记录的严重不良事件，该事件发生在一名患有慢性静脉溃疡的患者身上，其因微动静脉瘘（AVF）接受TAME治疗。该患者出现了严重并发症，包括腿部广泛肿胀、皮肤改变以及需要长期住院治疗的蜂窝织炎。这些发现凸显了患者选择和栓塞剂考量对于减轻与TAME相关潜在风险的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6761/12313676/cba83f38e9d5/fradi-05-1613940-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6761/12313676/bd5f90fe84aa/fradi-05-1613940-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6761/12313676/d2b6662b5df4/fradi-05-1613940-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6761/12313676/648a3785152b/fradi-05-1613940-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6761/12313676/cba83f38e9d5/fradi-05-1613940-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6761/12313676/bd5f90fe84aa/fradi-05-1613940-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6761/12313676/d2b6662b5df4/fradi-05-1613940-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6761/12313676/648a3785152b/fradi-05-1613940-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6761/12313676/cba83f38e9d5/fradi-05-1613940-g004.jpg

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1
Severe complications following transarterial microembolization for a micro arterio-venous fistula in a patient with chronic venous ulcer: a case report.经动脉微栓塞治疗慢性静脉溃疡患者微动静脉瘘后发生的严重并发症：一例报告
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本文引用的文献

1
Challenges and complications and their management of the transarterial microembolization for chronic musculoskeletal pain.经动脉微栓塞治疗慢性肌肉骨骼疼痛的挑战、并发症及其处理。
Eur Radiol. 2024 May;34(5):3260-3270. doi: 10.1007/s00330-023-10328-5. Epub 2023 Oct 19.
2
Intra-Arterial Injection of Temporary Embolic Material Through a Needle Inserted into the Radial or Ulnar Artery for Distal and Proximal Interphalangeal Joint Osteoarthritis: A Retrospective Study of 92 Patients.经桡动脉或尺动脉插入针行动脉内注射临时栓塞材料治疗远侧和近侧指间关节骨关节炎：92 例患者的回顾性研究。
Cardiovasc Intervent Radiol. 2023 Oct;46(10):1375-1382. doi: 10.1007/s00270-023-03514-x. Epub 2023 Jul 31.
3
Effectiveness and Safety of Intra-arterial Imipenem/Cilastatin Sodium Infusion for Patients with Hand Osteoarthritis-Related Interphalangeal Joint Pain.
经动脉注射亚胺培南/西司他丁钠治疗手部骨关节炎相关指间关节疼痛的有效性和安全性。
J Vasc Interv Radiol. 2023 Sep;34(9):1485-1492.e1. doi: 10.1016/j.jvir.2023.05.035. Epub 2023 Jun 7.
4
Transarterial Embolization for the Treatment of Chronic Musculoskeletal Pain: A Systematic Review of Indications, Safety, and Efficacy.经动脉栓塞治疗慢性肌肉骨骼疼痛：适应证、安全性及疗效的系统评价
ACR Open Rheumatol. 2022 Mar;4(3):209-217. doi: 10.1002/acr2.11383. Epub 2021 Nov 29.
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Multicenter Randomized Sham Controlled Study of Genicular Artery Embolization for Knee Pain Secondary to Osteoarthritis.多中心随机假手术对照研究：膝关节炎性膝痛的关节内动脉栓塞治疗。
J Vasc Interv Radiol. 2022 Jan;33(1):2-10.e2. doi: 10.1016/j.jvir.2021.09.019. Epub 2021 Oct 2.
6
Midterm Clinical Outcomes and MR Imaging Changes after Transcatheter Arterial Embolization as a Treatment for Mild to Moderate Radiographic Knee Osteoarthritis Resistant to Conservative Treatment.经导管动脉栓塞术治疗保守治疗无效的轻至中度影像学膝关节骨关节炎的中期临床疗效及磁共振成像变化
J Vasc Interv Radiol. 2017 Jul;28(7):995-1002. doi: 10.1016/j.jvir.2017.02.033. Epub 2017 Mar 30.