Stambo G W, Hallisey M J, Gallagher J J
Department of Vascular and Interventional Radiology, Hartford Hospital, CT 06102-5037, USA.
Ann Vasc Surg. 1996 Sep;10(5):476-80. doi: 10.1007/BF02000596.
The purpose of this study was to determine the safety and efficacy of transcatheter embolization in the management of bleeding visceral artery pseudoaneurysms. Eight patients (four women and four men) whose mean age was 61.0 years (range 44 to 77 years) underwent emergency transcatheter embolization for acute hemorrhage from a visceral artery pseudoaneurysm. Arteriographic technique was used to localize and selectively embolize these seven visceral artery pseudoaneurysms (three inferior pancreaticoduodenal, one gastroduodenal, two hepatic, and one splenic) by means of intravascular steel coils. Arteriography demonstrated visceral artery pseudoaneurysms in all eight patients. Acute hemorrhage was documented by endoscopy, falling hematocrit levels, CT scans, and arteriography. Successful embolization of these visceral artery pseudoaneurysms was achieved in seven (88%) of eight patients. In one patient embolization was not attempted because of a worsening clinical status, and this patient subsequently underwent emergency surgical resection. There was no significant morbidity associated with the procedures and seven patients remain asymptomatic with no further bleeding at a mean follow-up of 21.1 months (range 11 to 46 months). Arteriographic embolization of visceral artery pseudoaneurysms is a safe and highly successful technique for the effective identification and treatment of hemorrhage even in critically ill patients.
本研究的目的是确定经导管栓塞术治疗内脏动脉假性动脉瘤出血的安全性和有效性。8例患者（4例女性，4例男性），平均年龄61.0岁（范围44至77岁），因内脏动脉假性动脉瘤急性出血接受了急诊经导管栓塞术。采用血管造影技术定位并通过血管内钢圈选择性栓塞7个内脏动脉假性动脉瘤（3个胰十二指肠下动脉、1个胃十二指肠动脉、2个肝动脉和1个脾动脉）。血管造影显示所有8例患者均存在内脏动脉假性动脉瘤。通过内镜检查、血细胞比容水平下降、CT扫描和血管造影记录急性出血情况。8例患者中有7例（88%）成功栓塞了这些内脏动脉假性动脉瘤。1例患者因临床状况恶化未尝试栓塞，该患者随后接受了急诊手术切除。这些操作未导致明显的并发症，7例患者在平均21.1个月（范围11至46个月）的随访中仍无症状，无进一步出血。即使对于重症患者，内脏动脉假性动脉瘤的血管造影栓塞术也是一种安全且非常成功的技术，可有效识别和治疗出血。
