脾动脉瘤的介入治疗

目的探讨介入血管腔内治疗脾动脉瘤的临床价值。方法 16例脾动脉瘤患者,其中真性脾动脉瘤10例,假性脾动脉瘤6例,介入治疗术前均经血管超声、CT及DSA明确诊断。14例行弹簧圈动脉瘤或载瘤动脉栓塞术,2例采用支架辅助弹簧圈瘤体内填塞。患者术后3天和1周复查血常规和血淀粉酶;术后1周、3个月、6个月CT增强扫描复查。结果 14例弹簧圈栓塞患者术后CT增强扫描均未见栓塞以远脾动脉主干显影,动脉瘤体无对比剂填充,2例支架辅助弹簧圈瘤体内填塞患者术后3个月、6个月CT增强扫描示脾动脉主干及分支血管血流通畅,瘤体无对比剂填充。7例出现低热,8例有左侧季肋区隐痛,低热及腹痛症状均在3～5天缓解或消失,8例载瘤动脉栓塞患者2天血淀粉酶复查有不同程度升高,1周复查时恢复正常。结论介入血管腔内治疗是一种简便、微创、安全、有效的治疗真、假性脾动脉瘤的方法。

Interventional Therapy of Splenic Artery Aneurysms and Pseudoaneurysms

Objective To evaluate the value of the endovascular interventional therapy in treatment of splenic artery aneurysms and pseudoaneurysms.Methods Sixteen patients with splenic artery aneurysms(n=10) and false aneurysms(n=6) proveded by color doppler ultrasound,CT and DSA angiography were collected in the study.Embolization with coils were carried out to the artery aneurysms or parent artery in 14 cases.Coils were deployed into the aneurysms assisted by stents in 2 case.Routine blood tests and serum amylase were checked at 3 and 7 days after the procedure.Enhanced CT was performed at 7 days,3 and 6 months after the procedure.Results The splenic artery has been embolized successfully in 14 cases.The aneurysms and pseudoaneurysms in all patients were not enhanced on CT angiography at 3 or 6 months after embolization.Complete aneurysms thrombosis and normal splenic artery branching has been showed on CT images 3 or 6 months after the stents and coils implanted in 2 cases.Low grade fever and bellyache were occurred after embolization in 7 and 8 cases respectively,which were relieved after 3 to 5 days.Transient elevation of serum amylase was recovered in 1 week in 5 patients.Conclusion Endovascular treatment is a simple,minimally invasive,safe and effective treatment for splenic artery aneurysms and pseudoaneurysms.