覆膜支架治疗难治性股动脉假性动脉瘤的探讨_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

成青鉴 ¹ ,  何瑜媛 ¹ , 车辙 ¹ , 高鹏程 ¹ , 吴继东 ²

1. ;
2. ;

Corresponding author：

何瑜媛, Email: heyy_3681128@163.com

Keywords：

覆膜支架; 股动脉; 假性动脉瘤

DOI：

10.7507/1007-9424.201901017

Video：

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目的探讨覆膜支架置入治疗难治性股动脉假性动脉瘤的有效性及其安全性。方法 2012 年 8 月至 2017 年 8 月期间，河西学院附属张掖人民医院血管外科共收治了 26 例难治性股动脉假性动脉瘤患者，其中属外伤性股动脉假性动脉瘤 20 例，医源性股动脉假性动脉瘤 6 例；26 例中有 8 例合并股动-静脉瘘。26 例患者术前全部经彩超检查得以确诊，并在彩超引导下进行常规压迫或瘤腔内注射血凝酶治疗，但均未获成功，26 例患者最终改行股动脉覆膜支架置入术治疗，其中 4 例同期行血肿清除术，2 例行假性动脉瘤腔内穿刺引流术。结果全部患者一期置入覆膜支架均获成功，股动脉假性动脉瘤及动-静脉瘘均治愈，6 例患者股深动脉封闭，无手术死亡及严重并发症发生。术后 6 个月及 12 个月进行随访，26 例患者均无瘤体复发及支架移位、断裂、栓塞和内瘘发生。结论覆膜支架置入治疗难治性股动脉假性动脉瘤是安全、有效、微创的方法，其短期效果满意，远期疗效有待进一步观察。

Citation： 成青鉴, 何瑜媛, 车辙, 高鹏程, 吴继东. 覆膜支架治疗难治性股动脉假性动脉瘤的探讨. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2019, 26(7): 861-864. doi: 10.7507/1007-9424.201901017 Copy

1.	严振辉, 洪居陆, 柳学国, 等. 股动脉假性动脉瘤病因及治疗方法分析. 中国血管外科杂志(电子版), 2015, 7(2): 107-111.
2.	陈刚, 郑黎晖, 吴灵敏, 等. 超声引导下穿刺抽吸血肿加人工压迫治疗医源性股动脉假性动脉瘤. 中国循环杂志, 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.	潘福顺, 谢晓燕, 林颖, 等. 超声引导下加压治疗医源性股动脉假性动脉瘤. 中华外科杂志, 2012, 50(3): 302-305.
7.	江沛, 史树贵, 王益, 等. 超声引导下注射凝血酶治疗医源性假性动脉瘤. 局部手术学杂志, 2016, 25(5): 342-346.
8.	姚佐懿, 罗菲菲, 周翔宇, 等. 超声引导下经皮凝血酶注射对医源性股动脉复杂假性动脉瘤的应用研究. 重庆医学, 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, 陈松旺, 黄岩, 等. 超声引导下瘤体旁注射0.9%氯化钠溶液治疗股动脉假性动脉瘤18例. 介入放射学杂志, , 2018, 27(2): 163-166.
12.	罗国新, 向定成, 王莎莎, 等. Angioseal治疗难治性股动脉假性动脉瘤二例. 介入放射学杂志, 2011, 20(1): 74-75.
13.	蒙喜云. 覆膜支架置入治疗吸毒导致的假性动脉瘤. 重庆医科大学, 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.	吴鉴今, 曲乐丰, 柏骏, 等. ViabahnTM自膨式覆膜支架腔内修复外周动脉创伤性假性动脉瘤. 介入放射学杂志, 2015, 24(7): 632-636.
20.	颜海燕, 孙建明. Viabahn^TM自膨式覆膜支架腔内修复注射毒品所致股动脉假性动脉瘤9例. 介入放射学杂志, 2017, 26(2): 123-127.
21.	冯建新, 何建平, 高万河, 等. 覆膜支架在创伤性股动脉假性动脉瘤治疗中的临床应用价值. 陕西医学杂志, 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, 文晓蓉, 赵纪春, 等. 彩色多普勒超声辅助无造影剂腹主动脉瘤合并髂内动脉瘤腔内覆膜支架修复术. 中国普外基础与临床杂志, 2018, 25(6): 728-734.
25.	张希全, 葛世堂, 陈众, 等. 多种介入方法治疗内脏动脉瘤32例经验. 中国普外基础与临床杂志, 2019, 26(3): 307-311.
26.	郭宝磊, 郭大乔, 符伟国. 股腘动脉支架断裂的研究进展. 中华普通外科学文献(电子版), 2015, 9(1): 51-54.

1. 严振辉, 洪居陆, 柳学国, 等. 股动脉假性动脉瘤病因及治疗方法分析. 中国血管外科杂志(电子版), 2015, 7(2): 107-111.
2. 陈刚, 郑黎晖, 吴灵敏, 等. 超声引导下穿刺抽吸血肿加人工压迫治疗医源性股动脉假性动脉瘤. 中国循环杂志, 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. 潘福顺, 谢晓燕, 林颖, 等. 超声引导下加压治疗医源性股动脉假性动脉瘤. 中华外科杂志, 2012, 50(3): 302-305.
7. 江沛, 史树贵, 王益, 等. 超声引导下注射凝血酶治疗医源性假性动脉瘤. 局部手术学杂志, 2016, 25(5): 342-346.
8. 姚佐懿, 罗菲菲, 周翔宇, 等. 超声引导下经皮凝血酶注射对医源性股动脉复杂假性动脉瘤的应用研究. 重庆医学, 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, 陈松旺, 黄岩, 等. 超声引导下瘤体旁注射0.9%氯化钠溶液治疗股动脉假性动脉瘤18例. 介入放射学杂志, , 2018, 27(2): 163-166.
12. 罗国新, 向定成, 王莎莎, 等. Angioseal治疗难治性股动脉假性动脉瘤二例. 介入放射学杂志, 2011, 20(1): 74-75.
13. 蒙喜云. 覆膜支架置入治疗吸毒导致的假性动脉瘤. 重庆医科大学, 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. 吴鉴今, 曲乐丰, 柏骏, 等. ViabahnTM自膨式覆膜支架腔内修复外周动脉创伤性假性动脉瘤. 介入放射学杂志, 2015, 24(7): 632-636.
20. 颜海燕, 孙建明. Viabahn^TM自膨式覆膜支架腔内修复注射毒品所致股动脉假性动脉瘤9例. 介入放射学杂志, 2017, 26(2): 123-127.
21. 冯建新, 何建平, 高万河, 等. 覆膜支架在创伤性股动脉假性动脉瘤治疗中的临床应用价值. 陕西医学杂志, 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, 文晓蓉, 赵纪春, 等. 彩色多普勒超声辅助无造影剂腹主动脉瘤合并髂内动脉瘤腔内覆膜支架修复术. 中国普外基础与临床杂志, 2018, 25(6): 728-734.
25. 张希全, 葛世堂, 陈众, 等. 多种介入方法治疗内脏动脉瘤32例经验. 中国普外基础与临床杂志, 2019, 26(3): 307-311.
26. 郭宝磊, 郭大乔, 符伟国. 股腘动脉支架断裂的研究进展. 中华普通外科学文献(电子版), 2015, 9(1): 51-54.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

覆膜支架治疗难治性股动脉假性动脉瘤的探讨

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