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

摘要

目的 彩超引导下医源性股动脉复杂假性动脉瘤(IFACP)腔内经皮凝血酶注射治疗(UGTI)方法学及可行性评价.方法 回顾性分析32例经股动脉径路进行介入操作术后并发IFACP患者接受经皮凝血酶注射治疗.假性动脉瘤瘤腔数目为2腔23例,3腔8例,4腔1例;局部麻醉后彩超持续引导下动脉穿刺针依次进入各瘤腔进行凝血酶注射,动态观察瘤腔内血栓形成完成封堵,24 h,7d后分别彩超随访.结果 23例2腔全部一次性成功,2例3腔24 h后复查部分再通,再次行UGTI封堵失败,1例4腔封堵失败,均无血栓形成、栓塞、感染、过敏等并发症.结论 彩超引导下UGTI是治疗股IFACP首选术式,精准定位穿刺可提高复杂假性动脉瘤治疗成功率,避免严重并发症.%Objective The aim to assess the methodology and feasibility of ultrasound guided percutaneous thrombin injection(UGTI) for the treatment of Iarogenic Femoral Arterial Complexity Pseudoaneurysms(IFACP).Methods Thirty two iarogenic femoral arterial complexity pseudoaneurysms patients following femoral arerial puncture for arterial angiography were treated with UGTI.Twenty-three IFACP with 2 lobes,8 IFACP with 3 lobes,1 IFACP with 4 lobes.Under local anesthesia the lobe was pene trated by artery needle successively and thrombin jection was performed slowely into distal lobe with US guide precise localization.Dynamical observation was performed for the status of thrombogenesis and cavity plugging.US follow-up examination were performed after 24 h and 7 d.Results Reperfusion occurred in IFACP with 3 lobes after 24 h and UGTI failure.IFACPs with 4 lobes failure.Nothromboembolic,infectious,allergic complication soccurred.Conclusion UGTI is the first mothed for the treatment of IFACP.Precise localization and percutaneous can enhance the ratio of treatment of IFACPs and avoid the severe complications.