摘要
目的 评价腔内治疗医源性血管损伤（IVI）的近期疗效.方法 对2002年7月至2010年7月解放军总医院血管外科收治的21例接受腔内治疗的IVI进行回顾性分析.IVI类型包括主动脉损伤2例,外周动脉损伤11例,内脏动脉损伤5例,动静脉损伤1例,静脉损伤2例.其中15例IVI植入腔内移植物,4例IVI接受弹簧圈栓塞,1例IVI接受腔内球囊封闭裂口联合经皮假性动脉瘤腔内凝血酶注射,1例IVI接受腔内球囊压迫止血.结果 技术成功率100％,临床成功（达到有效止血和血流动力学稳定）20例（95.2％）,术中死亡1例,术后脑梗死2例,部分肾梗死1例.19例患者获得随访,平均随访时间23.9个月（4～84个月）,除了1例静脉支架术后3周塌陷并血栓形成导致症状反复,其余所有患者无并发症.结论 腔内技术对处理不同类型IVI的近期疗效显著,其远期结果还有待进一步随访观察.
Objective To evaluate the early outcome of endovascular management of iatrogenic vascular injury （IVI）.Methods From July 2002 to July 2010,21 cases of IVI undergoing endovasculr therapy were studied retrospectively.There were aorta injury （ n =2）,peripheral artery injury （ n =11 ）,visceral artery injury （n =5）,arteriovenous injury （n =1） and venous injury （n =2）.And the procedures included endograft implantation （ n =15 ）,intravascular embolization with coil （ n =4 ）,combination of endovascular balloon intervention and percutaneous thrombin injection （ n =1 ） and balloon compression for hemostasis （n =1 ）.Results Technical success was achieved in all patients.And clinical success,defined as arrested hemorrhage and hemodynamic stabilization,was obtained in 20 （95.2%） patients.There was one case of intra-operative mortality.After the procedure,there were cerebral infarction （ n =2） and partial renal infarction （ n =1 ）. Among them,19 patients received a median follow-up period of 23.9 months （ range：4 - 84 months）.Only 1 patient with iliofemoral vein stent implantation developed stent collapse and thrombosis at Week 3.There were no other complications.Conclusion Endovascular therapy is an effective procedure in the management of different types of IVI.Despite its encouraging early results,the long-term outcomes require further follow-ups and observations.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2012年第5期312-315,共4页
National Medical Journal of China
关键词
手术中并发症
血管内手术
Intraoperative complication
Endovascular procedures
