经血管腔内治疗21例内脏动脉瘤的临床疗效

目的：评价血管腔内治疗内脏动脉瘤的安全性及疗效。方法：回顾总结经血管腔内治疗21例内脏动脉瘤患者的资料；其中男性15例．女性6例；年龄23～72岁（平均49岁）；真性动脉瘤17例，假性动脉瘤9例（医源性8例，创伤后1例）；瘤体位于脾动脉10例，肝动脉7例。肾动脉4例，肠系膜动脉3例，胃左动脉1例，腹腔动脉1例。17例行经导管动脉瘤体栓塞术＋载瘤动脉栓塞术；4例行覆膜支架植入术；1例联合行动脉瘤体栓塞术＋支架植入术；3例瘤体直径〈2cm的动脉瘤未干预。结果：21饲患者手术成功率为100％，除2例出现轻度脾梗死症状外，未见明显手术并发症。术后随访5～42个月（平均19．1个月）未见动脉瘤破裂出血、动脉瘤复发或增大；支架内及分支动脉血流均保持通畅；3例未干预动脉瘤者未见动脉瘤增大及相关并发症。结论：经血管腔内栓塞或覆膜支架植入术治疗内脏动脉瘤安全、有效。

Transcather Endovascular Treatment of Visceral Artery Aneurysms:Clinical Outcome of 21 Patients

Objective： To evaluate transcatheter endovascular interventional techniques in treatment of visceral artery aneurysms（VAAs）. Methods： Patient records were retrospectively reviewed between 2000 and 2008 for VAA cases treated with catheter-based techniques in our department. 21 patients （6 women; mean age 49 ± 26 years） with 26 （9 false and 17 true） VAAs were identified,of which 10 involved the splenic artery,7 hepatic,4 renal, 3 superior mesenteric, I left gastric and 1 celiac. Transcatheter endovascular coil embolization was used in 17 VAAs. Stent graft placements were used to treat 4 patients. Combination of the endovascular embolization and stent placement in the SMA was performed in 1 patient with SMA areurysm. 3 VAAs which diameter shorter than 2 centimeters were kept observed. Results： Technical success was achieved in all cases with no significant complications except for slight symptoms of splenic infarction. An average follow-up of 19.1 months revealed no recurrence of areurysms and Doppler ultrasound scan showed patency of stent grafts. 3 uninterfered VVAs showed no augmentation and complications. Conclution：Transcatheter endovascular interventional techniques are safe and effective methods for the treatment of visceral artery aneurysms.