Schwartz R A, Teitelbaum G P, Katz M D, Pentecost M J
Department of Radiology, Los Angeles County-University of Southern California Medical Center.
J Vasc Interv Radiol. 1993 May-Jun;4(3):359-65. doi: 10.1016/s1051-0443(93)71876-x.
The authors describe their 11-year experience with transcatheter embolization (TCE) in the treatment of patients with hemorrhagic hepatic injuries.
Twenty-eight TCE procedures were performed in 24 patients between 1980 and 1991. Injuries in 21 patients were due to vehicular or criminal trauma; in three patients, injuries were iatrogenic. There were 21 male and three female patients (age range, 6-64 years). All patients underwent angiography and had evidence of active hemorrhage, pseudoaneurysm, or arteriovenous fistula (AVF). All embolizations were performed with use of Gianturco coils, microcoils, or gelatin sponge.
TCE was technically successful in occluding hepatic vascular lesions in 21 of 24 patients (88%). Technical failures were due to the inability to select the appropriate vessel for embolization in two cases and due to a persistent AVF that did not occlude despite further attempts at embolization. Lesions recurred in two patients who underwent initially successful TCE. Both patients were treated effectively with repeated TCE. Only two catheter-related complications were encountered, both after successful TCE. Twenty-one patients survived to be discharged from the hospital. Two patients among the group treated successfully and one from the group in whom treatment failed died.
This experience demonstrates that TCE is effective in the management of hepatic vascular injuries due to trauma.
作者描述了他们在经导管栓塞术（TCE）治疗出血性肝损伤患者方面的11年经验。
1980年至1991年间，对24例患者进行了28次TCE手术。21例患者的损伤是由车辆或刑事创伤所致；3例患者的损伤是医源性的。有21例男性和3例女性患者（年龄范围6 - 64岁）。所有患者均接受了血管造影，并有活动性出血、假性动脉瘤或动静脉瘘（AVF）的证据。所有栓塞均使用Gianturco弹簧圈、微弹簧圈或明胶海绵进行。
TCE在技术上成功闭塞了24例患者中21例（88%）的肝血管病变。技术失败的原因是两例无法选择合适的血管进行栓塞，以及一例尽管进一步尝试栓塞仍未闭塞的持续性AVF。两名最初TCE成功的患者病变复发。两名患者均通过重复TCE得到有效治疗。仅在TCE成功后出现两例与导管相关的并发症。21例患者存活出院。成功治疗组中有两名患者和治疗失败组中有一名患者死亡。
该经验表明TCE在治疗创伤性肝血管损伤方面是有效的。
