头臂动脉瘤和动静脉瘘的腔内治疗
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黄建华 E-mail:huangjianhua@medmail.com.cn

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Endovascular therapy for brachiocephalic pseudoaneurysm and carotid arteriovenous fistula
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    摘要:

    目的:探讨头臂血管假性动脉瘤(BCPA)或颈动脉静脉瘘(CVEF)患者的腔内治疗效果。
    方法:2003年9月—2011年3月笔者诊治10例假性动脉瘤和动静脉瘘患者并行腔内治疗,其中假性动脉瘤7例,先天性动静脉畸形2例,外伤性动静脉瘘1例。假性动脉瘤的病因为外伤或医源性损伤;临床表现为颈部或锁骨下搏动性肿块,病程2 h至40年不等。10例均经股动脉穿刺造影明确病变性质、部位、大小,然后采用放射介入方法,用带膜支架封堵病变处破口,重朔血管。
    结果:8例假性动脉或外伤性动脉静脉瘘及1例先天性动静脉瘘达到满意疗效,1例先天性动静脉瘘畸形明显好转,动静脉瘘流量明显减少。
    结论:头臂部动脉瘤或动静脉瘘采用带膜支架腔内隔绝治疗方法微创、简便、迅速、安全、有效,有实用价值。

    Abstract:

    Objective:To invesigate the effects of endovascular therapy on brachiocephalic pseudoaneurysm (BCPA) and carotid arteriovenous fistula (CVEF).
    Methods:The clinical data of 7 patients with BCPA and 3 patients with CAVF, admitted to our department from September 2003 to March 2011, were analysed. Durations of the diseases ranged from 2 h to 40 years.  The causes of pseudoaneurysm were traumatic and iatrogenic injury, of CAVF were  2 cases of congenital CAVF and 1 case of traumatic CAVF. The main clinical manifestation of both was pulsatile mass in the neck or infraclavicular region. Firstly, all patient underwent femoral artery puncture and angiography to identify the natnre, location and size of the lesion. Then, memberane-covered stents were inserted to seal the arterial perforations and repair the vessels.
    Results:Eight cases of pseudoaneurysm or traumatic arteriovenous fistula and 1 case of congenital arteriovenous fistula achieved satisfactory curative effect; another case of congenital arteriovenous fistula was substantially improved as evidenced by the obviously decreased blood flow through the fistula.
    Conclusions:Endovascular treatment with covered stent is a practically valuable method for brachiocephalic pseudoaneurysm and caroted arteriovenous fistula, this technique is simple, rapid, minimally invasive, safe and effective.

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黄建华|刘光强|王宪伟|欧阳洋|王伟|吕新生|李刚.头臂动脉瘤和动静脉瘘的腔内治疗[J].中国普通外科杂志,2011,20(6):564-567.
DOI:10.7659/j. issn.1005-6947.2011.06.002

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  • 收稿日期:2011-04-30
  • 最后修改日期:2011-06-11
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  • 在线发布日期: 2011-06-15