覆膜支架治療難治性股動脈假性動脈瘤的探討_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

成青鑒 ¹ ,  何瑜媛 ¹ , 車轍 ¹ , 高鵬程 ¹ , 吳繼東 ²

1. ;
2. ;

Corresponding?author：

何瑜媛, Email: heyy_3681128@163.com

Keywords：

覆膜支架; 股動脈; 假性動脈瘤

DOI：

10.7507/1007-9424.201901017

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目的探討覆膜支架置入治療難治性股動脈假性動脈瘤的有效性及其安全性。方法 2012 年 8 月至 2017 年 8 月期間，河西學院附屬張掖人民醫院血管外科共收治了 26 例難治性股動脈假性動脈瘤患者，其中屬外傷性股動脈假性動脈瘤 20 例，醫源性股動脈假性動脈瘤 6 例；26 例中有 8 例合并股動-靜脈瘺。26 例患者術前全部經彩超檢查得以確診，并在彩超引導下進行常規壓迫或瘤腔內注射血凝酶治療，但均未獲成功，26 例患者最終改行股動脈覆膜支架置入術治療，其中 4 例同期行血腫清除術，2 例行假性動脈瘤腔內穿刺引流術。結果全部患者一期置入覆膜支架均獲成功，股動脈假性動脈瘤及動-靜脈瘺均治愈，6 例患者股深動脈封閉，無手術死亡及嚴重并發癥發生。術后 6 個月及 12 個月進行隨訪，26 例患者均無瘤體復發及支架移位、斷裂、栓塞和內瘺發生。結論覆膜支架置入治療難治性股動脈假性動脈瘤是安全、有效、微創的方法，其短期效果滿意，遠期療效有待進一步觀察。

Citation： 成青鑒, 何瑜媛, 車轍, 高鵬程, 吳繼東. 覆膜支架治療難治性股動脈假性動脈瘤的探討. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2019, 26(7): 861-864. doi: 10.7507/1007-9424.201901017 Copy

1.	嚴振輝, 洪居陸, 柳學國, 等. 股動脈假性動脈瘤病因及治療方法分析. 中國血管外科雜志(電子版), 2015, 7(2): 107-111.
2.	陳剛, 鄭黎暉, 吳靈敏, 等. 超聲引導下穿刺抽吸血腫加人工壓迫治療醫源性股動脈假性動脈瘤. 中國循環雜志, 2017, 32(2): 170-173.
3.	Schneider C, Malisius R, Küchler R, et al. A prospective study on ultrasound-guided percutaneous thrombin injection for treatment of iatrogenic post-catheterisation femoral pseudoaneurysms. Int JCardiol, 2009, 131(3): 356-361.
4.	ElMahdy MF, Kassem HH, Ewis EB, et al. Comparison between ultrasound-guided compression and para-aneurysmal saline injection in the treatment of post-catheterization femoral artery pseudoaneurysms. Am J Cardiol, 2014, 113(5): 871-876.
5.	Dangas G, Mehran R, Kokolis S, et al. Vascular complications after percutaneous coronary interventions following hemostasis with manual compression versus arteriotomy closure devices. J Am Coll Cardiol, 2001, 38(3): 638-641.
6.	潘福順, 謝曉燕, 林穎, 等. 超聲引導下加壓治療醫源性股動脈假性動脈瘤. 中華外科雜志, 2012, 50(3): 302-305.
7.	江沛, 史樹貴, 王益, 等. 超聲引導下注射凝血酶治療醫源性假性動脈瘤. 局部手術學雜志, 2016, 25(5): 342-346.
8.	姚佐懿, 羅菲菲, 周翔宇, 等. 超聲引導下經皮凝血酶注射對醫源性股動脈復雜假性動脈瘤的應用研究. 重慶醫學, 2017, 46(4): 450-452.
9.	Lenartova M, Tak T. Iatrogenic pseudoaneurysm of femoral artery: case report and literature review. Clin Med Res, 2003, 25(3): 243-247.
10.	Tan KK, Chen K, Chia KH, et al. Surgical management of infected pseudoaneurysms in intravenous drug abusers:single institution experience and a proposed algorithm. World J Surg, 2009, 33(9): 1830-1835.
11.	周云, 陳松旺, 黃巖, 等. 超聲引導下瘤體旁注射0.9%氯化鈉溶液治療股動脈假性動脈瘤18例. 介入放射學雜志, , 2018, 27(2): 163-166.
12.	羅國新, 向定成, 王莎莎, 等. Angioseal治療難治性股動脈假性動脈瘤二例. 介入放射學雜志, 2011, 20(1): 74-75.
13.	蒙喜云. 覆膜支架置入治療吸毒導致的假性動脈瘤. 重慶醫科大學, 2013: 292-295.
14.	Coley BD, Roberts AC, Fellmeth BD, et al. Postangiographic femoral artery pseudoaneurysms: further experience with US-guided compression repair. Radiology, 1995, 194(2): 307-311.
15.	Lumsden AB, Miller JM, Kosinski AS, et al. A prospective evaluation of surgically treated groin complications following percutaneous cardiac procedures. Am Surg, 1994, 60(2): 132-137.
16.	Ricci MA, Trevisani GT, Pilcher DB. Vascular complications of cardiac catheterization. Am J Surg, 1994, 167(4): 375-378.
17.	Kuma S, Morisaki K, Kodama A, et al. Ultrasound-guided percutaneous thrombin injection for post-catheterization pseudoaneurysm. Circ J, 2015, 79(6): 1277-1281.
18.	Hirsch AT, Haskal ZJ, Hertzer NR, et al. ACC/AHA 2005 guidelines for the management of patients with peripheral arterial disease (lower extremity, renal, mesenteric, and abdominal aortic). J Am Coll Cardiol, 2006, 47(11): 1239-1312.
19.	吳鑒今, 曲樂豐, 柏駿, 等. ViabahnTM自膨式覆膜支架腔內修復外周動脈創傷性假性動脈瘤. 介入放射學雜志, 2015, 24(7): 632-636.
20.	顏海燕, 孫建明. Viabahn^TM自膨式覆膜支架腔內修復注射毒品所致股動脈假性動脈瘤9例. 介入放射學雜志, 2017, 26(2): 123-127.
21.	馮建新, 何建平, 高萬河, 等. 覆膜支架在創傷性股動脈假性動脈瘤治療中的臨床應用價值. 陜西醫學雜志, 2014, 43(11): 1496-1497.
22.	Geraghty PJ, Mewissen MW, Jaff MR, et al. Three-year results of the VIBRANT trial of VIABAHN endoprosthesis versus bare nitinol stent implantation for complex superficial femoral artery occlusive disease. J Vasc Surg, 2013, 58(2): 386-395.
23.	Mofidi R, Bhat R, Nagy J, et al. Endovascular repair of a ruptured mycotic aneurysm of the common iliac artery. Cardiovasc Intervent Radiol, 2007, 30(5): 1029-1032.
24.	袁丁, 文曉蓉, 趙紀春, 等. 彩色多普勒超聲輔助無造影劑腹主動脈瘤合并髂內動脈瘤腔內覆膜支架修復術. 中國普外基礎與臨床雜志, 2018, 25(6): 728-734.
25.	張希全, 葛世堂, 陳眾, 等. 多種介入方法治療內臟動脈瘤32例經驗. 中國普外基礎與臨床雜志, 2019, 26(3): 307-311.
26.	郭寶磊, 郭大喬, 符偉國. 股腘動脈支架斷裂的研究進展. 中華普通外科學文獻(電子版), 2015, 9(1): 51-54.

1. 嚴振輝, 洪居陸, 柳學國, 等. 股動脈假性動脈瘤病因及治療方法分析. 中國血管外科雜志(電子版), 2015, 7(2): 107-111.
2. 陳剛, 鄭黎暉, 吳靈敏, 等. 超聲引導下穿刺抽吸血腫加人工壓迫治療醫源性股動脈假性動脈瘤. 中國循環雜志, 2017, 32(2): 170-173.
3. Schneider C, Malisius R, Küchler R, et al. A prospective study on ultrasound-guided percutaneous thrombin injection for treatment of iatrogenic post-catheterisation femoral pseudoaneurysms. Int JCardiol, 2009, 131(3): 356-361.
4. ElMahdy MF, Kassem HH, Ewis EB, et al. Comparison between ultrasound-guided compression and para-aneurysmal saline injection in the treatment of post-catheterization femoral artery pseudoaneurysms. Am J Cardiol, 2014, 113(5): 871-876.
5. Dangas G, Mehran R, Kokolis S, et al. Vascular complications after percutaneous coronary interventions following hemostasis with manual compression versus arteriotomy closure devices. J Am Coll Cardiol, 2001, 38(3): 638-641.
6. 潘福順, 謝曉燕, 林穎, 等. 超聲引導下加壓治療醫源性股動脈假性動脈瘤. 中華外科雜志, 2012, 50(3): 302-305.
7. 江沛, 史樹貴, 王益, 等. 超聲引導下注射凝血酶治療醫源性假性動脈瘤. 局部手術學雜志, 2016, 25(5): 342-346.
8. 姚佐懿, 羅菲菲, 周翔宇, 等. 超聲引導下經皮凝血酶注射對醫源性股動脈復雜假性動脈瘤的應用研究. 重慶醫學, 2017, 46(4): 450-452.
9. Lenartova M, Tak T. Iatrogenic pseudoaneurysm of femoral artery: case report and literature review. Clin Med Res, 2003, 25(3): 243-247.
10. Tan KK, Chen K, Chia KH, et al. Surgical management of infected pseudoaneurysms in intravenous drug abusers:single institution experience and a proposed algorithm. World J Surg, 2009, 33(9): 1830-1835.
11. 周云, 陳松旺, 黃巖, 等. 超聲引導下瘤體旁注射0.9%氯化鈉溶液治療股動脈假性動脈瘤18例. 介入放射學雜志, , 2018, 27(2): 163-166.
12. 羅國新, 向定成, 王莎莎, 等. Angioseal治療難治性股動脈假性動脈瘤二例. 介入放射學雜志, 2011, 20(1): 74-75.
13. 蒙喜云. 覆膜支架置入治療吸毒導致的假性動脈瘤. 重慶醫科大學, 2013: 292-295.
14. Coley BD, Roberts AC, Fellmeth BD, et al. Postangiographic femoral artery pseudoaneurysms: further experience with US-guided compression repair. Radiology, 1995, 194(2): 307-311.
15. Lumsden AB, Miller JM, Kosinski AS, et al. A prospective evaluation of surgically treated groin complications following percutaneous cardiac procedures. Am Surg, 1994, 60(2): 132-137.
16. Ricci MA, Trevisani GT, Pilcher DB. Vascular complications of cardiac catheterization. Am J Surg, 1994, 167(4): 375-378.
17. Kuma S, Morisaki K, Kodama A, et al. Ultrasound-guided percutaneous thrombin injection for post-catheterization pseudoaneurysm. Circ J, 2015, 79(6): 1277-1281.
18. Hirsch AT, Haskal ZJ, Hertzer NR, et al. ACC/AHA 2005 guidelines for the management of patients with peripheral arterial disease (lower extremity, renal, mesenteric, and abdominal aortic). J Am Coll Cardiol, 2006, 47(11): 1239-1312.
19. 吳鑒今, 曲樂豐, 柏駿, 等. ViabahnTM自膨式覆膜支架腔內修復外周動脈創傷性假性動脈瘤. 介入放射學雜志, 2015, 24(7): 632-636.
20. 顏海燕, 孫建明. Viabahn^TM自膨式覆膜支架腔內修復注射毒品所致股動脈假性動脈瘤9例. 介入放射學雜志, 2017, 26(2): 123-127.
21. 馮建新, 何建平, 高萬河, 等. 覆膜支架在創傷性股動脈假性動脈瘤治療中的臨床應用價值. 陜西醫學雜志, 2014, 43(11): 1496-1497.
22. Geraghty PJ, Mewissen MW, Jaff MR, et al. Three-year results of the VIBRANT trial of VIABAHN endoprosthesis versus bare nitinol stent implantation for complex superficial femoral artery occlusive disease. J Vasc Surg, 2013, 58(2): 386-395.
23. Mofidi R, Bhat R, Nagy J, et al. Endovascular repair of a ruptured mycotic aneurysm of the common iliac artery. Cardiovasc Intervent Radiol, 2007, 30(5): 1029-1032.
24. 袁丁, 文曉蓉, 趙紀春, 等. 彩色多普勒超聲輔助無造影劑腹主動脈瘤合并髂內動脈瘤腔內覆膜支架修復術. 中國普外基礎與臨床雜志, 2018, 25(6): 728-734.
25. 張希全, 葛世堂, 陳眾, 等. 多種介入方法治療內臟動脈瘤32例經驗. 中國普外基礎與臨床雜志, 2019, 26(3): 307-311.
26. 郭寶磊, 郭大喬, 符偉國. 股腘動脈支架斷裂的研究進展. 中華普通外科學文獻(電子版), 2015, 9(1): 51-54.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

覆膜支架治療難治性股動脈假性動脈瘤的探討

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