Therapy experience of multiple interventional technologies for visceral artery aneurysms in 32 cases_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 ZHANG Xiquan , GE Shitang , CHEN Zhong , DOU Shubin , LU Shengyue , WANG Xin

Interventional Endovascular Treatment Center, No. 960 Hospital of PLA, Zibo, Shandong 255300, P. R. China;

Corresponding?author：

ZHANG Xiquan, Email: jrkzxq@163.com

Keywords：

visceral artery aneurysm; interventional therapy; bare stent; covered stent; coil

DOI：

10.7507/1007-9424.201811007

Video：

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Objective To investigate treatment methods and effect of endovascular interventional therapy for visceral artery aneurysms.Methods The clinical data of 32 patients with visceral artery aneurysms, who were treated in the No. 960 Hospital of PLA from February 2011 to April 2018, were retrospectively analyzed. It was proveded by the CT or digital subtraction angiography before the interventional therapy. The implantation of covered stent, coil embolization together with stent implantation, double stents placement or pure coil embolization were performed. The postoperative antithrombotic therapy was adopted in the patients accepted the stent implantation. The CT angiography was performed on the month of 1, 6, 12, 24 or the patient was uncomfortable after the treatment to evaluate the obstruction condition of the aneurysms, stent blood flow, and branches arteries, etc..Results The success rate of the endovascular interventional therapy was 100%. In the 11 patients underwent the implantation of covered stent, the postoperative angiography showed that the stent lumen was patent and the aneurysm was not visualized. In the 9 patients underwent the coil embolization together with stent implantation and 3 patients underwent the double stents placement, the postoperative angiography results of the aneurysm showed that it was faintly visualized and the branch arteries were not involved. In the 9 patients underwent the pure coil embolization, the postoperative angiography showed that the aneurysm was not visualized. No perioperative mortality or procedure related complications occurred. No case was lost during the follow-up of a median period of 25.5 (6–48) months. During the follow-up, one patient developed the mild abdominal pain in one month, which disappeared after the symptomatic medication management. Except for 1 patient developed the mild stent stenosis (<30%) on the 12th month after the procedure, the stent and the branch arteries of the other patients were completely patent, and no aneurysms recurred.Conclusion For treatment of visceral artery aneurysms, endovascular interventional therapy is safe and effective and shows an excellent short-term and mid-term effects.

Citation： ZHANG Xiquan, GE Shitang, CHEN Zhong, DOU Shubin, LU Shengyue, WANG Xin. Therapy experience of multiple interventional technologies for visceral artery aneurysms in 32 cases. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2019, 26(3): 307-311. doi: 10.7507/1007-9424.201811007 Copy

1.	郭偉, 衛任. 內臟動脈瘤腔內治療進展. 中國血管外科雜志 (電子版), 2012, 4(3): 129-132.
2.	Tessier DJ, Abbas MA, Fowl RJ, et al. Management of rare mesenteric arterial branch aneurysms. Ann Vasc Surg, 2002, 16(5): 586-590.
3.	Mohan IV, Stephen MS. Peripheral arterial aneurysms: open or endovascular surgery? Prog Cardiovasc Dis, 2013, 56(1): 36-56.
4.	景在平, 宋超, 陸清聲. 內臟動脈瘤腔內治療的現狀及問題. 中華普通外科雜志, 2012, 27(7): 521-522.
5.	張希全, 葛世堂, 朱偉, 等. 自發性孤立性腸系膜上動脈夾層的血管腔內介入治療體會. 中國普外基礎與臨床雜志, 2017, 24(4): 449-452.
6.	Acosta S, Asciutto G. Endovascular therapy for visceral artery aneurysms. Int Angiol, 2016, 35(6): 573-578.
7.	Carroccio A, Jacobs TS, Faries P, et al. Endovascular treatment of visceral artery aneurysms. Vasc Endovascular Surg, 2007, 41(5): 373-382.
8.	孫小杰, 胡何節, 王曉天, 等. 內臟動脈瘤 41 例治療分析. 中國血管外科雜志 (電子版), 2017, 9(1): 32-36.
9.	Gehlen JM, Heeren PA, Verhagen PF, et al. Visceral artery aneurysms. Vasc Endovascular Surg, 2011, 45(8): 681-687.
10.	Regus S, Lang W. Rupture risk and etiology of visceral artery aneurysms and pseudoaneurysms: a single-center experience. Vasc Endovascular Surg, 2016, 50(1): 10-15.
11.	張萌帆, 韓新巍, 張凱, 等. 覆膜支架和密網支架在復雜內臟動脈瘤的治療應用 (附 12 例病例分析). 臨床放射學雜志, 2015, 34(2): 267-270.
12.	Dorigo W, Pulli R, Azas L, et al. Early and intermediate results of elective endovascular treatment of true visceral artery aneurysms. Ann Vasc Surg, 2016, 30: 211-218.
13.	Ruhnke H, Kr?ncke TJ. Visceral artery aneurysms and pseudoaneurysms: retrospective analysis of interventional endovascular therapy of 43 aneurysms. Rofo, 2017, 189(7): 632-639.
14.	黃駿詠, 馮家煊, 馮睿, 等. 血管腔內治療腹腔干動脈瘤 16 例效果分析. 介入放射學雜志, 2016, 25(6): 491-495.
15.	張偉, 張曦彤, 田玉龍, 等. 不銹鋼彈簧圈填塞治療內臟動脈瘤 8 例. 介入放射學雜志, 2016, 25(4): 308-311.
16.	史巖鵬, 王東林, 劉金朝. 內臟動脈瘤血管腔內治療方法和效果探討. 當代醫學, 2014, 20(34): 65-66.
17.	劉凌曉, 顏志平, 王建華, 等. 經導管介入治療內臟動脈瘤 (附 65 例報道). 復旦學報 (醫學版), 2011, 38(3): 216-220, 246.
18.	Rabellino M, García-Nielsen L, Zander T, et al. Stent-assisted coil embolization of a mycotic renal artery aneurysm by use of a self-expanding neurointerventional stent. Cardiovasc Intervent Radiol, 2011, 34(Suppl 2): S109-S112.
19.	林文曉, 郭平凡, 蔡方剛. 28 例內臟動脈瘤的治療體會. 福建醫科大學, 2014.
20.	郭建明, 谷涌泉, 俞恒錫, 等. 腔內與開放手術治療腹腔干及其分支動脈瘤療效對比分析. 中國實用外科雜志, 2013, 33(12): 1031-1033, 1037.
21.	Zhang W, Fu YF, Wei PL, et al. Endovascular repair of celiac artery aneurysm with the use of stent grafts. J Vasc Interv Radiol, 2016, 27(4): 514-518.
22.	Augsburger L, Farhat M, Reymond P, et al. Effect of flow diverter porosity on intraaneurysmal blood flow. Klin Neuroradiol, 2009, 19(3): 204-214.
23.	常光其, 王冕. 多層裸支架治療累及分支動脈的主動脈病變的思考. 中華外科雜志, 2015, 53(11): 805-808.
24.	Zhang Y, Lu Q, Zhao Z, et al. Multiple overlapping uncovered stents as an alternative flow-diverting strategy in the management of peripheral and visceral aneurysms. J Vasc Surg, 2014, 60(5): 1209-1217.
25.	Ruffino MA, Rabbia C, Italian Cardiatis Registry Investigators Group. Endovascular repair of peripheral and visceral aneurysms with the cardiatis multilayer flow modulator: one-year results from the Italian Multicenter Registry. J Endovasc Ther, 2012, 19(5): 599-610.

1. 郭偉, 衛任. 內臟動脈瘤腔內治療進展. 中國血管外科雜志 (電子版), 2012, 4(3): 129-132.
2. Tessier DJ, Abbas MA, Fowl RJ, et al. Management of rare mesenteric arterial branch aneurysms. Ann Vasc Surg, 2002, 16(5): 586-590.
3. Mohan IV, Stephen MS. Peripheral arterial aneurysms: open or endovascular surgery? Prog Cardiovasc Dis, 2013, 56(1): 36-56.
4. 景在平, 宋超, 陸清聲. 內臟動脈瘤腔內治療的現狀及問題. 中華普通外科雜志, 2012, 27(7): 521-522.
5. 張希全, 葛世堂, 朱偉, 等. 自發性孤立性腸系膜上動脈夾層的血管腔內介入治療體會. 中國普外基礎與臨床雜志, 2017, 24(4): 449-452.
6. Acosta S, Asciutto G. Endovascular therapy for visceral artery aneurysms. Int Angiol, 2016, 35(6): 573-578.
7. Carroccio A, Jacobs TS, Faries P, et al. Endovascular treatment of visceral artery aneurysms. Vasc Endovascular Surg, 2007, 41(5): 373-382.
8. 孫小杰, 胡何節, 王曉天, 等. 內臟動脈瘤 41 例治療分析. 中國血管外科雜志 (電子版), 2017, 9(1): 32-36.
9. Gehlen JM, Heeren PA, Verhagen PF, et al. Visceral artery aneurysms. Vasc Endovascular Surg, 2011, 45(8): 681-687.
10. Regus S, Lang W. Rupture risk and etiology of visceral artery aneurysms and pseudoaneurysms: a single-center experience. Vasc Endovascular Surg, 2016, 50(1): 10-15.
11. 張萌帆, 韓新巍, 張凱, 等. 覆膜支架和密網支架在復雜內臟動脈瘤的治療應用 (附 12 例病例分析). 臨床放射學雜志, 2015, 34(2): 267-270.
12. Dorigo W, Pulli R, Azas L, et al. Early and intermediate results of elective endovascular treatment of true visceral artery aneurysms. Ann Vasc Surg, 2016, 30: 211-218.
13. Ruhnke H, Kr?ncke TJ. Visceral artery aneurysms and pseudoaneurysms: retrospective analysis of interventional endovascular therapy of 43 aneurysms. Rofo, 2017, 189(7): 632-639.
14. 黃駿詠, 馮家煊, 馮睿, 等. 血管腔內治療腹腔干動脈瘤 16 例效果分析. 介入放射學雜志, 2016, 25(6): 491-495.
15. 張偉, 張曦彤, 田玉龍, 等. 不銹鋼彈簧圈填塞治療內臟動脈瘤 8 例. 介入放射學雜志, 2016, 25(4): 308-311.
16. 史巖鵬, 王東林, 劉金朝. 內臟動脈瘤血管腔內治療方法和效果探討. 當代醫學, 2014, 20(34): 65-66.
17. 劉凌曉, 顏志平, 王建華, 等. 經導管介入治療內臟動脈瘤 (附 65 例報道). 復旦學報 (醫學版), 2011, 38(3): 216-220, 246.
18. Rabellino M, García-Nielsen L, Zander T, et al. Stent-assisted coil embolization of a mycotic renal artery aneurysm by use of a self-expanding neurointerventional stent. Cardiovasc Intervent Radiol, 2011, 34(Suppl 2): S109-S112.
19. 林文曉, 郭平凡, 蔡方剛. 28 例內臟動脈瘤的治療體會. 福建醫科大學, 2014.
20. 郭建明, 谷涌泉, 俞恒錫, 等. 腔內與開放手術治療腹腔干及其分支動脈瘤療效對比分析. 中國實用外科雜志, 2013, 33(12): 1031-1033, 1037.
21. Zhang W, Fu YF, Wei PL, et al. Endovascular repair of celiac artery aneurysm with the use of stent grafts. J Vasc Interv Radiol, 2016, 27(4): 514-518.
22. Augsburger L, Farhat M, Reymond P, et al. Effect of flow diverter porosity on intraaneurysmal blood flow. Klin Neuroradiol, 2009, 19(3): 204-214.
23. 常光其, 王冕. 多層裸支架治療累及分支動脈的主動脈病變的思考. 中華外科雜志, 2015, 53(11): 805-808.
24. Zhang Y, Lu Q, Zhao Z, et al. Multiple overlapping uncovered stents as an alternative flow-diverting strategy in the management of peripheral and visceral aneurysms. J Vasc Surg, 2014, 60(5): 1209-1217.
25. Ruffino MA, Rabbia C, Italian Cardiatis Registry Investigators Group. Endovascular repair of peripheral and visceral aneurysms with the cardiatis multilayer flow modulator: one-year results from the Italian Multicenter Registry. J Endovasc Ther, 2012, 19(5): 599-610.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Therapy experience of multiple interventional technologies for visceral artery aneurysms in 32 cases

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