CAJ | 학술논문

目的总结分析主髂动脉病变腔内治疗术中髂动脉术中破裂及延迟破裂的处理.方法回顾性分析北京大学人民医院自2008年11月至2014年8月收治的225例主髂动脉病变腔内治疗术中发生的8例髂动脉破裂的临床资料,包括术中即刻发现的破裂4例,延迟破裂4例,所有患者主髂动脉病变均为TASC D级.7例采用覆膜支架封堵破口,1例放弃治疗. 结果所有接受治疗患者均成功置入覆膜支架,术后造影明确髂动脉破口完全封堵,技术成功率100％.术后循环均恢复稳定,腹痛症状消失,1例患者术前心功能衰竭,术后死于多器官功能衰竭,1例死于误吸.随访时间分别为9、12、12、13、52个月,随访期间无再发髂动脉破裂、支架内再狭窄等并发症发生.结论髂动脉破裂出血,特别是髂动脉延迟破裂是主髂动脉病变腔内治疗过程中一种常见的危险并发症,使用覆膜支架封堵出血点,是髂动脉破裂出血的一种安全、迅速、有效的治疗方法.
목적 총결분석주가동맥병변강내치료술중가동맥술중파렬급연지파렬적처리.방법 회고성분석북경대학인민의원자2008년11월지2014년8월수치적225례주가동맥병변강내치료술중발생적8례가동맥파렬적림상자료,포괄술중즉각발현적파렬4례,연지파렬4례,소유환자주가동맥병변균위TASC D급.7례채용복막지가봉도파구,1례방기치료. 결과 소유접수치료환자균성공치입복막지가,술후조영명학가동맥파구완전봉도,기술성공솔100％.술후순배균회복은정,복통증상소실,1례환자술전심공능쇠갈,술후사우다기관공능쇠갈,1례사우오흡.수방시간분별위9、12、12、13、52개월,수방기간무재발가동맥파렬、지가내재협착등병발증발생.결론 가동맥파렬출혈,특별시가동맥연지파렬시주가동맥병변강내치료과정중일충상견적위험병발증,사용복막지가봉도출혈점,시가동맥파렬출혈적일충안전、신속、유효적치료방법.
Objective To evaluate iliac artery rupture during endovascular treatment of aorto-iliac disease and treatment with covered stent.Methods From November 2008 to August 2014,iliac artery rupture happened in 8 patients of 225 patients of aorto-iliac artery disease admitted to our hospital.Clinical data of the 8 patients were analyzed retrospectively.Four were of intraoperative rupture and four were of delayed rupture.The aorto-iliac diease of all the 8 patients were TSAC D.Direct placement of a covered stent was performed in all the cases,except for one patient who refused further treatment.Results All of the procedures finally achieved technical success and all patients become hemodynamically stable.One patient was complicated with heart failure who died of multiple organ dysfunction syndrome.Another one died of aspiration.5 patients were followed up from 9-52 moths,average 9-52 moths without recurrence.Conclusions Iliac artery rupture is a serious and life-threatening complication in the endovascular treatment of aorto-iliac disease.Covered stent provided a safe and effective treatment for iliac perforations.