Kramann B, Daoyu H, Kubale R, Schneider G
Abteilung für Radiodiagnostik, Radiologische Klinik, Universitätskliniken des Saarlandes.
Rofo. 1995 Nov;163(5):417-23. doi: 10.1055/s-2007-1016019.
The authors report on their experience in endovascular embolization therapy in 13 cases with splanchnic artery aneurysms or pseudoaneurysms.
Three patients suffered from true aneurysms, ten patients presented pseudoaneurysms of different origin. Eight patients were transferred to our department for life-threatening intestinal bleeding. Five patients showed transpapillary bleeding, four of whom presented with haemobilia and one patient had intermittent bleeding into the pancreatic duct due to a true aneurysm of the splenic artery. Embolization was performed using a coaxial microcatheter coil delivery system. In 4 patients the aneurysm-bearing vessel was temporarily blocked during the intervention.
In 11 patients definite occlusion of the aneurysm was obtained without surgical intervention. In one patient, suffering from a splenic aneurysm, we observed a partial inadvertent embolisation of the spleen which did not require further treatment. In one case, rupture of an hepatic aneurysm during embolization occurred. One patient with pseudoaneurysm due to displacement of a port catheter showed severe rebleeding one day after embolisation.
Transcatheter embolization is an effective method for treatment of aneurysms of the splanchnic arteries. To avoid life-threatening bleeding due to rupture of the aneurysm, the feeding vessel should be temporarily blocked during embolization therapy.
作者报告了他们对13例内脏动脉瘤或假性动脉瘤进行血管内栓塞治疗的经验。
3例为真性动脉瘤,10例为不同起源的假性动脉瘤。8例因危及生命的肠道出血转入我科。5例出现经乳头出血,其中4例表现为胆道出血,1例因脾动脉真性动脉瘤导致间歇性胰管出血。使用同轴微导管弹簧圈输送系统进行栓塞。4例患者在介入过程中对载瘤血管进行了临时阻断。
11例患者未经手术干预即实现了动脉瘤的明确闭塞。1例脾动脉瘤患者,我们观察到脾脏意外部分栓塞,无需进一步治疗。1例患者在栓塞过程中肝动脉瘤破裂。1例因门静脉导管移位导致假性动脉瘤的患者在栓塞后一天出现严重再出血。
经导管栓塞是治疗内脏动脉瘤的有效方法。为避免因动脉瘤破裂导致危及生命的出血,在栓塞治疗期间应临时阻断供血血管。