血管栓塞术成功治疗创伤后肾动脉假性动脉瘤

Dr KEYUR PATEL, Dr RAJENDRA B NERLI, Dr NAVIN MULIMANI, Dr SHREYAS RAI, Dr ABHINAY JOGULA, Dr ASHWIN BOKARE, Dr NISHANT SETYA
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摘要

肾动脉假性动脉瘤是钝性肾创伤的一种罕见并发症。对于血流动力学稳定的患者,超选择性血管栓塞术是一种微创、有效的治疗外伤性肾动脉假性动脉瘤的方法。我们报告了用血管栓塞术治疗外伤后出血假性动脉瘤患者的经验。材料和方法:我们回顾性地查看了本院所有有肾脏钝伤史、因大量血尿入院并接受血管栓塞术控制出血的患者的住院和门诊病历及影像学资料。研究结果在研究期间,有 3 名患者(均为男性)因腹部钝伤就诊,平均年龄为 26.66 岁。对比计算机断层扫描(CT)显示,2 名患者为 IV 级肾损伤,1 名患者为 V 级损伤。在肾实质撕裂的部位发现局灶性强化区,提示假性动脉瘤。进行了超选择性导管插入术,并使用 50%N-丁基-2-氰基丙烯酸酯(NBCA)+ Lipiodol 进行栓塞。结论血管栓塞术是一种放射学干预手段,是一种有效的微创技术,可用于止住肾动脉假性动脉瘤的活动性出血。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Post-Traumatic Renal Artery Pseudoaneurysm Managed Successfully with Angioembolization
Renal artery pseudoaneurysm is a rare complication of blunt renal trauma. Super-selective angioembolization is aminimally invasive, effective procedure to manage traumatic renal artery pseudoaneurysm, in patients who are hemodynamicallystable. We report our experience in the management of patients with post-traumatic bleeding pseudoaneurysm withangioembolization. Materials and methods: We retrospectively reviewed the inpatient and outpatient records and imagingdata of our hospital, of all patients with history of blunt injury to kidneys, admitted with massive hematuria and underwentangioembolization to control the bleeding. Results: During the study period, 3 patients (all male) with a mean age of 26.66 yearspresented to us with blunt injury abdomen. Contrast computed tomography (CT) revealed Grade IV renal injury in 2 patientsand Grade V injury in 1 patient. Focal intensively enhancing areas were noted at the site of renal parenchymal lacerationssuggestive of pseudoaneurysms. Super-selective catheterization was performed and embolization done using 50% N-butyl-2-cyanoacrylate (NBCA) + Lipiodol. Conclusions: Angioembolization, a radiographic intervention, is an effective and minimallyinvasive technique to stop active bleeding from renal artery pseudoaneurysms.
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